1. A Dietitian’s Experience with Pediatric Obesity… El Paso, TX and Ogden, UT Pervasive bad habits What works

2. Disclosure Slide √ I have no conflicts of interest concerning this presentation

3. Breakfast 1 Cherry Pop-Tart 12 ounces orange juice Microwave sausage patty Lunch 16 ounces Mountain Dew 6 chicken nuggets Small French fries, 2.5 oz. Dinner 2 slices pepperoni pizza 12 ounce Coke Snacks 2 ounces Hot Cheetos 12 ounces Coke 2 drumstick ice cream cones 16 ounces SunnyD

4. The Damage: 2845 kcalories 117 grams of fat 186 grams of sugar 3524 mg sodium 11.2 grams fiber 63% kcalories from fat & added sugar Low vitamin/mineral content

5. Breakfast 8 ounces 1% milk 1 cup Cheerios 1 medium banana 1 ounce cheddar cheese 1 slice whole wheat bread Lunch Peanut butter & apple sandwich on whole wheat (2 T. pb, 1 small apple) 4 mini bell peppers 2 T. hummus 8 ounces 1% milk Dinner 3 oz. lean grilled hamburger mayo, mustard, ketchup White bun ½ cup grilled squash/tomato 10 homemade French fries Snacks 2 homemade oatmeal cookies 8 ounces 1% milk 1 cup baby carrots 2 T. Ranch dressing Kashi Trail Mix granola bar 2 clementine cuties

6. Much Better: 2256 kcalories 79 grams of fat 33 grams of added sugar 2422 mg sodium 38 grams fiber 37% kcalories from fat and added sugar High vitamin/mineral content

7. Calorie Density The problem with sugar and fat…

8. Cut out or cut back on SUGARY BEVERAGES Regular sodas Fruitades and fruit drinks Fruit juice Energy drinks (Rockstar, Monster, Red Bull) *Caution with caffeine content*

9. 5-hour Energy1.9 fl. oz.208 mg Full Throttle16 fl. oz.200 mg Monster Energy16 fl. oz.160 mg Rockstar16 fl. oz.160 mg AMP Energy Boost Original 16 fl. oz.142 mg Red Bull8.4 fl. oz. 80 mg V8 V-Fusion+Energy8 fl. oz. 80 mg Ocean Spray Cran- Energy 20 fl. oz. 55 mg Glacéau Vitaminwater Energy 20 fl. oz. 50 mg Starbucks Refreshers 12 fl. oz. 50 mg Caffeine Content of Energy Drinks

10. Eat according to “Tummy Hunger” 3 Meals 2-3 Snacks Division of responsibility

11. Eat according to ChooseMyPlate.gov

12. ¼ Animal Foods ¾ Plant Foods Calcium Source C O L O R F U N Meals

14. What is a Healthy Snack? C O L O R F U N Combinations Fruit & peanut butter Natural cheese on a “raft” Raw veggies & “quicksand” “Polka dot” yogurt

15. What is a Portion? Palm-sized portions work well for children (and adults) for many foods VS.

16. Portions? Poker chip: Checkbook: Golf ball: Compact disc: Computer mouse: Deck of cards: Baseball: Children’s portions are ¼-½ of adult portions or 1 Tbsp/year

17. Prepare and eat dinner together as a family at the table VS.

18. Limit FAST FOOD to once a week or less if at all

19. Allow ONE small treat/day. Homemade is best.

20. Are YOU a Good Role Model?

21. Resources www.mnaap.org/obesityclinicalresources.html Pediatric Tool Kit: prescription in color or black and white; BMI calculator, growth charts, pediatric weight management protocols, additional resources www.choosemyplate.gov Interactive tools, trackers, recipes, meal and menu ideas www.kidnetic.com For the kids: activities, recipes, games, etc.

22. References www.mnaap.org/obesityclinicalresources.html www.choosemyplate.gov www.nal.usda.gov/fnic/foodcomp/Data/SR18/nutrlist/sr18list.html www.caloriecount.com Dietary Guidelines for Americans, 2010 American Dietetic Association (2012) Complete Food and Nutrition Guide, 4 th ed. Hoboken, New Jersey: John Wiley & Sons, Inc.

23. Questions?