1. Start Healthy, Stay Healthy™: a Nestlé Nutrition Initiative to Establish Healthy Eating Habits Early Kathleen Reidy, DrPH, RD Head, Nutrition Science,, Nestlé Infant Nutrition 1

2. 2 Start Healthy, Stay Healthy ™ is Gerber’s Commitment to Early Childhood Nutrition SCIENCE Elevate the nutrition conversation through scientific leadership PRODUCT INNOVATION Integrate developmental and nutrition science for advanced product design EDUCATION Translate complex nutrition science for all stakeholders

3. “What happens to a child during the first years of life is important to their current and future health and well-being… into adulthood. However, national efforts to prevent obesity have not paid enough attention to infants, toddlers, and preschool children. The committee’s report highlights the urgent need for early prevention.” Pregnancy Preschool Focus on Very Early Prevention is Critical, but Limited 3

4. Modifiable Factors Associated with Early Obesity (J Obesity, 2012) Lack of breastfeeding Diet quality and quantity: – Early introduction (< 4 months) of complementary foods – High intake of sweetened beverages – Low intake of fruit and vegetables Habitual ‘food away from home’ Lack of family meals Lack of responsive caregiver feeding behaviors (e.g., low attention to hunger and satiety cues; use of overly restrictive or controlling feeding ) Low nocturnal sleep duration TV / Screen viewing time; decreased active play Pregnancy Preschool 4

5. Science Driven: FITS Provides Great Insights about Children’s Diets 5 Dietary survey of over 3,000 infants & toddlers Snapshot of nutrient intakes and dietary patterns Fills an important information gap Published in 25+ peer-reviewed journal articles 2008 Key Findings Improvements in breastfeeding and delayed introduction of sweets Continuing lack of fruits and vegetables Infant and Toddler dietary gaps Preschooler diets high in sodium and saturated fats Sweets constitute almost 15% of preschooler calories 2002 Key Findings Lack of fruits and vegetables Sweets introduced very early Snacks contribute 30% of toddlers’ calories Infant and Toddler dietary gaps

6. FITS has helped in shaping efforts in childhood nutrition 6 Influencing Public Health PolicySharing with Health Professionals Changing Our Products and ServicesEducating Through the Media

7. FITS Insight: Parents Don’t Recognize Overweight 7 BMI CategoryTerminology < 5th percentileUnderweight 5th-84th percentileHealthy weight 85th-94th percentileOverweight ≥ 95th percentileObesity 24-59 Months NHANES, 1999-2004, 2007-2008 24-47 Months FITS 2008 Mei et al, J Pediatr 2008;153:622-8; Ogden et al JAMA 2010;303(3):242-9 National Health and Nutrition Examination Survey (NHANES) 1999-2004, 2007-2008 BMI Categories for Children 2-19 years Do you consider your child’s weight to be: FITS 2008 - Table 164, Recruitment Interview, Question E3 About right 89.1% Underweight 8.6% Overweight 2.2% Healthy weight 75.8% Underweight 3.0% Overweight 10.8% Obese 10.4%

8. Food Consumption Patterns are Set by 18 Months of Age Percent of Calories / Formula After 18 months of age, the consistency of intake by food group is remarkably constant. The stage is set for long term dietary patterns – and the current patterns are far from ideal FITS 2008 Percent of Energy From Major Food Groups 8

9. Most Parents Think Their Child’s Diet has Enough Fruit and Vegetables, BUT… 9 Source: FITS 2008 Percent of parents who think their child gets enough fruits and veggies

10. …Preschoolers are More Likely to have a Sweet than a Fruit or Vegetable 10 Percentage of Children Consuming *excludes fruit juice

11. 11 Gerber Innovation: Start Healthy, Stay Healthy ™ : Product Innovation FITS Insight : Lack of fruits and vegetables Inadequate intake of essential fats/high sat fat Whole grain gap Too many sweets and 25% of calories from snacks Lil’ Entrees – one serving of vegetables; cheese sauce made with squash Graduates Grabbers - fruit puree in self-feeding package Dairy products with healthier fats – Omega 3 from canola oil Pasta and finger foods made with whole grains Healthier snack alternatives – such as Yogurt and yogurt melts

12. Consumer Education is at the Heart of the SHSH System 12 Social 24/7 Call Center with RDs and lactation consultants Direct Mail Digital Mobile

13. Direct Mail Format was Designed by Millennial Moms 13 What it is: – Research driven format and style – Redefined to improve consumer comprehension – Objective educational content – Stronger link to digital assets to learn more Reaches: – Reaches approximately 2.1MM new moms/yr – Maintains engagement with 6.0MM moms/yr – Generates 24,000,000 impressions per year – Flexibility to update creative on a monthly basis Provides: – Information on nutritional needs and developmental milestones at each stage

14. Our 12-Video ‘How To’ Library Leverages Sight, Sound and Motion to Educate Moms 14 Why It Works: – Digital format highly relevant to today’s mom – Features Millennial Mom speaking (vs. Medical Professional) – 62,000 Views to Date – YouTube is the #2 Search Engine in America "How to" Videos on feeding at every stage of development: – How to add variety to your baby’s diet – How to Feed Your Toddler – Feeding a Picky Eater

15. Science Driven Tools: Interactive Menu Planner to Teach Mom about a Healthy Diet at Different Developmental Stages 15 Generates nutritionally- appropriate menus – Based on both nutrients and food groups  IOM, AAP and MyPyramid – Uses USDA nutrient database – Based on developmental stages – Interactive and customizable Meets consumer need – 600,000 gerber.com visits per month – 60,000 Menu Planner downloads per month

16. Growth Tracker Chart’s Baby’s Growth for You 16 Body Mass Index (BMI) Chart Weight & Length/Height Data

17. USDA Partner – Supporting MyPlate Educational Messages 17 Theme: Foods to Reduce Key Message: Drink water instead of sugary drinks

18. We Must Start Prevention Efforts Earlier: Known Modifiable Factors Associated with Early Obesity (J Obesity, 2012) Research is needed on HOW TO modify these factors Lack of breastfeeding Diet quality and quantity: – Early introduction (< 4 months) of complementary foods – High intake of sweetened beverages – Low intake of fruit and vegetables Habitual ‘food away from home’ Lack of family meals Lack of responsive caregiver feeding behaviors (e.g., low attention to hunger and satiety cues; use of overly restrictive or controlling feeding ) Low nocturnal sleep duration TV / Screen viewing time; decreased active play Pregnancy Preschool 18