Cathe Paul, MPH, BSN Katy Levenhagen, MS, RD Coalition for Safety and Health in Early Learning
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Transcript of Cathe Paul, MPH, BSN Katy Levenhagen, MS, RD Coalition for Safety and Health in Early Learning
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Preventing Childhood Obesity:Best Practice Strategies in Nutrition and
Physical Activity in Early Learning
Cathe Paul, MPH, BSNKaty Levenhagen, MS,
RD
Coalition for Safety and Health in Early
LearningThis project was made possible by funding from the Department of Health and Human Services and
Public Health - Seattle & King County
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What are “Best Practices”?
• Defined by Caring for Our Children: Preventing Childhood Obesity in Early Care and Education Programs, 2010
• “CFOC” = Best Practice Standards for Early Learning
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Outline for the Day• Morning
• Overview of Childhood Overweight/Obesity• Best Practices: Nutrition and Mealtime Socialization• Menu Planning and Mealtime Activities for Early Learning• 10:30 Smoothie Break
• Lunch - Farm to Workshop• Provided by Maya, Our Beginnings Child Care• Farm to Child Care Table: Presentation by Puget Sound
Food Network• Afternoon
• Wellness for Child Care Providers• Best Practices: Physical Activity and Screen Limits• Physical Activities for Early Learning• 2:30 Rhubarb/Apple Crisp Break• 3:15 Evaluations and Wrap-up
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Childhood Obesity
• Obese: BMI-for-age and sex > 95 %
• Overweight: BMI-for-age and sex > 85 %
• Healthy Weight: BMI-for-age and sex between 5th and less than 85th %
• Underweight: BMI-for-age and sex less than 5th %
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How Many Kids in Child Care
King County, 2008
• From Department of Early Learning, Child Care Resources, Regional Infant Toddler Planning Assessment King County Report, 10-1364, 10/8/2010
Total Centers Family
School Age 25,611 17,285 8326
Preschool 37,329 25,373 11,956
Toddlers 9923 6135 3788
Infants 5409 1785 3624
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Childhood Obesity RatesCDC data, 2008
•2 to 5 yrs has more than doubled (from 5% to 10.4%) during the past 3 decades.
•6 to 11 yrs has more than quadrupled, during past 4 decades (from 4.2% to 19.6%)
•12 to 19 yrs has more than tripled (from 4.6 to 18.1 percent) during the past four decades.)
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In Washington State 2008
14.4% of low income 2 - 5 year olds were obese
Pediatric Nutrition Surveillance Report, 2008,
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Long Term Health Risks
• Diabetes Type 2• High Blood
Pressure/Hypertension• High Cholesterol• Heart Disease/Stroke• Higher health care costs• Quality of Life issues
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Short Term Health Risks
• Premature puberty• Sleep Apnea• Asthma• Bone/joint issues social discrimination• Depression and low self-esteem• Risk for eating disorders
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“Thirty years ago, most people led lives that kept them at a healthy weight. Kids walked to and from school every day, ran around at recess, participated in gym class, and played for hours after school before dinner. Meals were home-cooked with reasonable portion sizes and there was always a vegetable on the plate. Eating fast food was rare and snacking between meals was an occasional treat.”
M. Obama, letsmove.gov
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Contributing Factors
• Too Many Calories– More added fats, sugar and salt– Too much food/more snacking– Larger servings – Lack of family meals
• Too much sedentary time/screen time• Lack of enough physical activity• Viewing more food advertisements
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NHLBI Portion Distortion Quiz
OEI-NHLBI Slide Show Menu Pagehttp://hp2010.nhlbihin.net/oei_ss/menu.htm#PD2
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Healthy Weight for Children
• Infant Feeding Practices• Nutrition• Mealtime Socialization• Screen Time Limits• Physical Activity
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Childhood Obesity PreventionInfants and Toddlers
• Breastfeed • Practice cue feeding • No TV, computer or media for babies under 2• Provide many opportunities for activity across the
day
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Breastfeeding plays an important role in obesity prevention and improving overall health outcomes, and therefore is vitally important to public health.”
United States Breastfeeding Committee, Chair, Joan Younger Meek, MD, MS, RD, IBCLC, Preventing Obesity Begins at Birth through Breastfeeding, Jan. 2011
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CFOC StandardsInfant Feeding
Support, encourage and accommodate
breastfeeding Moms
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CFOC StandardsInfant Feeding
• Feed according to baby’s cues– hunger and satiety– need time to explore
• Introduce solid foods:• Make a plan with parents• Preferably closer to 6 mths as
indicated by needs
Matt and Baby – Ellyn SatterOh Baby...Feeding Young Children in Group Settings
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Childhood Obesity PreventionNutrition
• Expose children to a wide variety of foods• Eat at home most often• Limit high calorie, highly processed foods• Limit sugar sweetened beverages and juice• Strive for 5-A-Day
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CFOC Nutrition Standards
• Serve a 3 component breakfast to all kids• 1% milk to kids over 2/whole for kids
under 2• Limit juice to < 2, 4 oz glasses a week• Limit high fat, sugar and sodium foods• Serve a fruit and/or vegetable at snack• Supplement parent supplied meals• Provide nutrition/education guidance to
parents
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Low fat, low sodiumless added sugar
• Less processed foods (canned, box, package)• More whole foods (fruits, veggies, whole
grains)• More foods made from “scratch” • Eat 5 servings of fruits and veggies/day
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ABCs of Menu Planning
• Nutrient Adequacy and Food Appeal– Meet CACFP meal pattern
• Balance – Ensure variety, at least 2 week
menu cycle,– limit juice to < 2/wk– Fruit and veggies for PM snack
• Calories – Serve 1% milk– Limit high fat, sugar and sodium foods to < 1/week
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Rate the Menu
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Break/Snack
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“We suggest that helping children attend to internal cues of hunger and satiety should be
promoted as a productive child-feeding strategy and as an alternative to coercive or restrictive
practices”.
Susan Johnson, PhD, Improving Prschoolers Self Regulation of Feeding Pediatrics, 2000
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Childhood Obesity PreventionMealtime Environment
• Eat together often (6-19 yrs)• Model healthy eating habits (Preschoolers)• Help children self regulate (infancy on)• Avoid using food for rewards or punishment (all)
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Division of Responsibility During Eating
Main goal - self regulation
• Adults decide what, when, where• Kids decide if, what and how much
Ellen Satter, Feeding with Love and Good Sense,
Bull Publishing, 2nd Edition, 2000
Video Clip:“When a parent asks for regulation”University of Idaho - Feeding Young Children in Group Settings - videos alphabetical
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CFOC Meal Time Standards
• Sit with kids• Eat with kids• Role Model• Serve family style• Let the kids help• Follow Division of ResponsibilityWatch video clips• Pouring• He’s Such a Picky EaterUniversity of Idaho - Feeding Young Children in Group Settings - videos
alphabetical
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I hear and I forget.I see and I remember.
I do and I understand and One picture is worth a thousand words.
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Lunch Time
Farm to Child Care TablePuget Sound Food Network
Presentation with Emma and Karen
www.psfn.org