Eating Lessons and Super Foods 2.7.09

Eating Lessons and Super Foods for Infants & Young Children (Birth to 5 Years) : Eating Lessons and Super Foods for Infants & Young Children (Birth to 5 Years) Presented By: Melissa Halas-Liang, MA RD CDE CNSD and Linda Piette, RD, MS, LD

User Terms : User Terms This presentation is not intended as medical advice and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. By participating in this seminar it constitutes an agreement by the participant not to hold the instructor or any individual or institution associated with the course liable from all claims arising out of or related to your access or use of, or your inability to access or use the information contained in this course or any information or materials linked to or viewed from this course or anyone else for any decision made or action taken by you in reliance on such information or for any consequential, special or similar damages, even if advised of the possibility of such damages.

Presentation Objectives : Presentation Objectives Identify early feeding experiences that shape food preferences and eating behavior. List family mealtime dos and don’ts that promote healthy eating patterns. Recognize developmental milestones that signal a child’s readiness for solid foods. Distinguish between food refusals that are normal and transitory versus those that require intervention.

Presentation Objectives : Presentation Objectives To recognize the importance of introducing a variety of fruits, vegetables, whole grains and beans in a child’s diet. To be able to list the benefits of specific phytonutrients, (plant compounds) and their role in wellness and disease prevention. To be able to state how eating these foods can help your child grow at a healthy weight. To understand how a parents eating habits, shapes and influences their children’s eating habits.

: Super Foods for KidsMelissa Halas-Liang, MA RD CDE CNSD,Instructor for Nutrition Certificate for Optimal Health, Wellness and Sport, www.efslibrary.net Editor in Chief, www.superkidsnutrition.comAuthor of Super Baby Abigail’s Lunch Time Adventure and Havoc at the Hillside Market Books purchased through the website, support the website

Health Outcomes : Health Outcomes Genetics play a major role in the development of disease However, most diseases are considered preventable or could be minimized by a healthy diet, fitness, weight management and an over-all healthier lifestyle (including controlling environmental factors)

Discovering Nature’s Answers : Discovering Nature’s Answers We need to take a closer look into nature which provides many disease fighting nutrients in abundance. A variety of foods have been proposed as providing health benefits by altering one or more physiologic processes. Greater understanding of how diet influences a person's genetic potential, overall performance, and susceptibility to disease can have enormous implications for society.

Discovering Nature’s Answers : Discovering Nature’s Answers We are only beginning to discover how nutrients in foods work together. In the future we’ll see how our genes, mindset and attitude affect how we digest and utilize many of the nutrients found in food.

Plant Benefits : Plant Benefits Fruits, vegetables whole grains, nuts and beans can Protect your DNA, eye sight, and memories. They slow aging, prevent cancer, heart disease and diabetes. Greatly contribute to growing healthy kids and providing healthy sustainable energy Abundant in plant compounds, called phytonutrients/phytochemicals.

What are phytonutrients? : What are phytonutrients? Active components of plants - thought to promote human health. Phytonutrients, antioxidants, vitamins and minerals found in plants that have protective or disease-fighting properties. Fruits, vegetables, grains, legumes, nuts and teas are rich sources of phytonutrients. Unlike the traditional nutrients (protein, fat, vitamins, minerals), phytonutrients are not "essential" for life, so they are also often referred to as "phytochemicals".

Phytonutrients Protect : Phytonutrients Protect Certain phyotnutrients have been reported to have multiple biological effects, including: antioxidant activity anti-inflammatory action inhibition of platelet aggregation antimicrobial activities antitumor activities Chopped garlic was found to be effective against killing vancomycin resistant Enterococci and methicillin-resistant staphlococcus aureus.

Phytonutrients May Protect Against Disease By: : Phytonutrients May Protect Against Disease By: Serve as antioxidants Enhance immune response Enhance cell-to-cell communication Alter estrogen metabolism Convert to vitamin A (beta-carotene is metabolized to vitamin A) Cause cancer cells to die (apoptosis) Repair DNA damage caused by smoking and other toxic exposures Detoxify carcinogens through the activation of the certain enzyme systems

Lemon : Lemon Lemons, great source of vitamin C and provide folate and potassium. Contain citrus limonoids shown to fight cancers of the mouth, skin, lung, breast, stomach, colon and human neuroblastoma tumors (which occur most often in children). Lemons have powerful anti proliferation activities –stop the growth/division of cells So easy to include in your diet, accent many meals and organic lemon rind is delicious in smoothies!

Plant Compounds Simplified : Plant Compounds Simplified An effective strategy for reducing risk of cancer and heart disease is to increase consumption of phytonutrient-rich foods including fruits, vegetables, whole-grains, beans and teas. Eat a variety of plant foods, they work together best as a team. They help: Keep us healthy Keep us at a healthy weight Fight off disease, germs & bacteria

How Plant Foods Protect People : How Plant Foods Protect People Plants have their own natural defense system to fight off invasion and be free of disease. These plant chemicals protect the plant from insects, disease and the sun. Some of these same plant chemicals that protect plants help protect people and have antibacterial, antiviral, anticancer and other helpful properties. Most often, you can’t get these plant chemicals in a pill you need to get them from the plant food in its whole form so all the plant compounds can work together –synergistic effect

Plant Foods : Plant Foods Provide us with vitamin and minerals that are needed for every day body activities. Because fruits and vegetables have low energy density (i.e., few calories relative to volume), eating them as part of a reduced-calorie diet can be beneficial for weight management In 1999-2002, adults only met 28% and 32% of fruit and vegetable guidelines, respectively.

Fruit and Veggie Intake in Kids : Fruit and Veggie Intake in Kids One quarter of all vegetables consumed by children and adolescents are French fries. Kid’s intakes of all fruits and of dark green and/or deep yellow vegetables are very low compared with recommendations. Fewer than 10% of 1- to 2- year-olds consume a dark green vegetable a day. Only one in five children consume five or more servings of fruits and vegetables per day. Parents need to find fun ways to expose children to a variety of fruits and vegetables at an early age: especially dark green and deep yellow vegetables. Utilize children’s books with healthy themes

Healthy Eyes, Heart & Body : Healthy Eyes, Heart & Body Orange/yellow fruits and vegetables are usually colored by natural plant pigments called carotenoids. Beta-carotene in sweet potatoes, pumpkins and carrots is converted to vitamin A, which helps maintain healthy mucous membranes and healthy eyes. Scientists have also reported that carotenoid-rich foods can help reduce risk of cancer, heart disease and can improve immune system function. One study found that people who ate a diet high in carotenoid-rich vegetables were 43 percent less likely to develop age-related macular degeneration, an eye disorder common among the elderly, which can lead to blindness.

How Plant Foods Help Keep You Healthy : How Plant Foods Help Keep You Healthy Processed foods which are very low in essential nutrients displaces foods rich in antioxidants and phytonutrients. These nutrients keep us healthy as we age and minimize disease risk. Kids and Adults need plant foods in a variety of types and colors Different nutrients stimulate the metabolic pathways of genes in different organs Another reason we need to eat variety, is we are uniquely different based on our genes.

Plant Foods Protect : Plant Foods Protect For example Glucosinolates a compound in cabbage activates the gene responsible for cleansing the body of toxins. If your gene doesn’t work efficiently this food is going to be more beneficial to you. Keep in mind, even if this specific gene is working properly, you are exposed to environmental toxins, medications etc that good nutrition can provide protection. Ideally we would want to avoid potential triggers of disease to which we are genetically susceptible, but it’s not always possible We are exposed to numerous triggers and our DNA may contain multiple predisposing genetic factors

Benefits of Cabbage : Benefits of Cabbage Cabbage protects the mucous membrane of the stomach from gastric hydrochloric acid. The gastroprotective effect of the juice is attributed to the regenerative ability of the mucous membrane that is caused by an anti-ulcer factor (vitamin U). Reduced breast cancer risk (2 cups per week) Cabbage Apple Slaw Slice thin ½ a head of cabbage. Add sliced apples, carrots, and raisin. Dressing: Olive oil and lemon juice. Season with salt and pepper

Pomegranates Protect : Pomegranates Protect Vitamin B6, an important vitamin that also keeps your heart healthy. Good source of polyphenols, antioxidants and have \ antibacterial properties. Help keep platelets and component in your blood from clumping together which can cause clots and lead to heart problems. Lower blood pressure. Help prevent atherosclerosis which is when a person’s arteries get too hard. Arteries should be be flexible to get blood to the right places. Pomegrantes can also protect against something called lipid peroxidation. This is a process that causes fats in our blood and body to become more harmful.

Eating Fruits, Vegetables, Beans and whole grains protects are DNA : Eating Fruits, Vegetables, Beans and whole grains protects are DNA As we get older each year our DNA gets older and worn down DNA is a list of instructions that we store in our body that tells our body what to do. Damage to our DNA piles up and can lead to changes in our genes which leads to heart disease and cancer Eating more plant based foods can help prevent this damage.

Every Day Foods verses Special Occasion : Every Day Foods verses Special Occasion Special Occasions Fruit Roll-Ups Alphabet cookies Squeezable yogurts Cheese food with over-processed crackers Trail mix with chocolate chips Every Day Fresh fruit Whole grain crackers Low fat yogurt sweetened with fresh fruit, apple butter or mashed fruit Low fat cheese & 100% whole grain crackers Trail mix with craisins Prepare pre-made ready to go healthy snacks

Every Day Foods verses Special Occasion : Every Day Foods verses Special Occasion Rarely Sweetened beverages Sugar coated rice -cakes Every Day Water, Low fat milk (organic when possible) Water splashed with juice Cucumber or lemon water Herbal fruit teas Whole grain rice cakes

Every Day Foods verses Special Occasion : Every Day Foods verses Special Occasion Special Occasions Veggie Chips Chips: Baked or Regular Freeze Dried Food Every Day Carrots or celery with nut butter (almond or peanut), or low fat cream cheese Jicama with cilantro splashed accented with orange juice Home made baked sweet potato fries Thinly sliced jicama or apples or other crunchy snacks Fresh fruit, dried fruit

Phytonutrients Research/Parent’s Influence : Phytonutrients Research/Parent’s Influence Research has also shown that a mother’s eating habits is closely related to their child’s eating habits. Children’s eating habits are established early in life, at preschool age. Parents do best by practicing food behaviors they want their children to model.

Weight and Plant Foods : Weight and Plant Foods As the prevalence of obesity has increased in younger children, researchers are looking to identify food selection patterns associated with weight status in preschool-aged children. In one study which involved parent reports preschool-aged children consumed more low-fat dairy and fewer sweetened drinks, ate salty and sweet snacks less frequently, more often consumed dinner with a parent, and watched fewer hours of TV on weekend days than school-aged children. Although preschool-aged children engaged in more healthful behaviors according to parent recall, the preschool-aged children did only meet 2 dietary recommendations, fruit and low-fat dairy intake.

A Healthy Life : A Healthy Life Parent-reported eating and leisure-time activity patterns did not meet current recommendations. Learning more about creating healthy families and communities can help children meet dietary and leisure-time activity recommendations. Programs which assist parents with preschool-aged children to develop skills and provide the structure and the environment necessary for their young children to develop a healthful lifestyle are critical to stop obesity from rising. Ask to review the snack list at your child’s day care center or pack your own. Get a local dietitian involved in program development. Bring healthy foods or non food options to birthday parties or classroom celebrations. Help make healthy eating fun!

A Healthy Life : A Healthy Life Avoid using food to manipulate children’s behavior (rewarding behavior w/certain foods or withholding certain foods as a punishment). For example, if you’re good you can have a special food treat. Parents often believe that consumption of certain foods (such as vegetables) should be encouraged and can force these foods, bargain or reward, not realizing that this can lead to dislikes of those foods. Food should be offered, not forced and behaviors modeled. Parents believe that consumption of certain foods should be discouraged and do not realize that this can lead to increased liking of these foods. Shop –Stock -Offer

Antioxidants : Antioxidants Nutrients and phytonutrients work together to protect cells. We have only begun to discover some powerful antioxidants. More on antioxidants is covered in my Functional Food: Nutrition and You & Public Nutrition and Wellness Education Courses Antioxidant can come in an repair the damage or stop the chain from continuing

What are your solutions to help increase fruits, veggies, whole grains and beans in the USA? How many servings do you, your family or children eat per day? What small steps can you take to create healthier living? : What are your solutions to help increase fruits, veggies, whole grains and beans in the USA? How many servings do you, your family or children eat per day? What small steps can you take to create healthier living?

A Healthy Life : A Healthy Life Parents purchase healthy foods, make them available and accessible in the home. Parents model healthy eating and fitness behaviors that their children imitate. Parents influence the extent of media exposure in the home, do not allow TV during meals, do screen products or advertising (commercials w/junk food), do not give in in to food pleas when shopping. Parents set the tone and interact with children, with these tips in mind

What is Peroxidation? : What is Peroxidation? Anthocyanin have anti-inflammatory activity and help prevent lipid peroxidation Peroxidation of polyunsaturated fatty acid residues in membranes can lead to major impairment of membrane function. Think about this….. the most consumed vegetable by America’s children is French Fries! Major Peroxidation!

Slide 35 : Yummy! Start a mini garden at home or at preschool with your child to create exposure and interest in plant based foods that do not come in a package.

An Apple a Day : An Apple a Day Rich source of phytochemicals. Epidemiological studies: reduced risk of some cancers, cardiovascular disease, asthma, and diabetes laboratory. Very strong antioxidant activity, inhibit cancer cell proliferation, decrease lipid oxidation, and lower cholesterol.

Apples Eat Them : Apples Eat Them Thinly slice an apple, sprinkle with a little cinnamon. Serve. Place a slice of apple and cheddar cheese on a whole wheat cracker for a quick snack. Peel and core an apple. Place apple on double layer of foil on a baking sheet. Dot the apple with a little butter. Sprinkle with brown sugar, add some raisins (or your favorite dried fruit

Go Bananas! : Go Bananas! Bananas -good source of vitamin C, B6, and fiber. Animal research found that bananas caused the cells that line the stomach to produce a thicker protective barrier against acid. Contain compounds called protease inhibitors that help destroy harmful bacteria such as H. Pylori.

Eat Basil! : Eat Basil! Rats who were administered Basil -holy basil had decreases in immune response to allergens Oil of basil has demonstrated strong antibacterial traits, even with antibiotic-resistant types. Effective in killing harmful bacteria found in produce.

Beans : Beans Can lower cholesterol, associated w/longer life. NHNE survey bean eaters are less likely to be obese. High consumption of beans was associated with a 82% reduction in heart disease, in one study. Reduced risk of breast cancer in postmenopausal women. Kids love bean dip. Make it together. Make a new tradition like taco Tuesday – try a new bean each week.

In Summary : In Summary We need to be promoting all super foods, when possible in season and always in a variety of colors. We need to promote acceptance and enjoyment of whole grains, fruits and vegetables from an early age. Whole foods will help achieve whole health. Encourage healthy eating at your school, make it the norm, not the exception. Find out more about the benefits of common super foods that can be consumed every day- lemons, bananas, and apples.

Webinar ConferenceFebruary 2009 Eating Lessons : Webinar ConferenceFebruary 2009 Eating Lessons Linda Piette, RD, MS Author of JUST TWO MORE BITES

Eating TogetherEating the same food? : Eating TogetherEating the same food?

Eating is a learned behavior. : Eating is a learned behavior. Biological Social Conditioning -healthy food choices -self-regulate calories

Early Feeding Experiences : Early Feeding Experiences Breast or bottle? -pitfalls -conditioning Flavor Exposure -in utero (Julie Mennella)

Distinct Food Flavors : Distinct Food Flavors 1st flavor…frt/veg Breast milk Avoid mush Avoid food in bottles Focus on flavor

Early Feeding Experiences : Early Feeding Experiences Experience shapes the brain Flavor nuance Oral-stimulation Flavor exposure

Kids learn from watching : Kids learn from watching 2-yr-olds recognize brand names. Preschoolers change vegetable preferences 1930’s Popeye cartoons -33% increase in spinach consumption

Slide 49 : Healthy Eating MEALTIME STRATEGIES

Mealtime Do’s : Mealtime Do’s Allow a child to express preferences Trust a child’s ability to self-regulate calories Respond to cues Support independence Get rid of baby food Create schedules and routines Establish a place for eating Provide good role models Set clear and consistent limits Practice patience

Ready for food? : Ready for food? Good head control Sitting up

Allow a child to express preference and control pace. : Allow a child to express preference and control pace. Young children do not eat alone Focus on child’s reactions Dialogue Shift in control

Trust a child’s ability to self-regulate calories. : Trust a child’s ability to self-regulate calories. “ Kids do not starve themselves?” Self-regulating calories -kids better than adults -family history of ED -?videos, dolls, conversations (Susan Johnson) Monitor growth – -give reassurance -recognize problems early

Eating TogetherEating the same food? : Eating TogetherEating the same food? Start early Table foods by 1st birthday. Get rid of baby food Foods introduced after age 4 more likely to be disliked. Nov 2002, 5-yr study J American Dietetic Assoc

Mealtime Don’ts : Mealtime Don’ts Offer giant portions Allow daylong grazing Force food Use distractions Offer bribes, punishments, and rewards Encourage long mealtimes Let kids throw food React emotionally to food refusals Reward food refusals

Don’t Force food. : Don’t Force food.

Part II : Part II Fussy Eater or… Something More? Poor Growth? Feeding Skill Delay? Parent Stress

Reasons kids refuse food: : Reasons kids refuse food: LIFE EXPERIENCES SOCIAL INFLUENCES DEVELOPMENT BIOLOGY/ HEALTH

Parent Concerns:Food Refusals : Parent Concerns:Food Refusals 33% of parents report this as a problem 1996 J of Pediatric Psychology 45%+ of young children

Typical Toddlers : Typical Toddlers Reduced growth rate. Exploring the world. Short attention span. Emerging self-feeding skills

Weekly Weight Gains : Weekly Weight Gains Age (months) Weight (ounces) 1-6 5-6 6-12 3-5 12-15 2 15-36 1.5 36-48 1.2 Source :JUST TWO MORE BITES

Age Related Problem : Age Related Problem 4-6 months = 19% 7-8 months = 25% 9-11 months = 29% 12-14 months = 35% 15-18 months = 46% 19-24 months = 50% Carruth, et al. “Prevalence of picky eaters among infants and toddlers and their caregiver’s decisions about offering a new food,” J of the American Dietetic Assoc. supp.1 Vol 104 (2004)

Typical Toddler Eating : Typical Toddler Eating Food Jags – Loves a food for weeks and then rejects it. Appetite Fluctuations- Eats a lot one day and little the next. Important to Note: Obnoxious but normal behaviors. Over-reacting to child’s early food refusals increases his risk later for obesity later in life.

Eating Milestones-Solids : Eating Milestones-Solids Closes lips around spoon (7-9 months) Uses tongue to move food from side to side (8-11 months) Teeth? Table foods by 1 year

Eating Milestones - Liquids : Eating Milestones - Liquids Drinking from a cup by 16 months Able to drink thin liquids without gagging Able to drink 6 oz within 10 minutes/ less

Make Eating Easier : Make Eating Easier FOOD TEXTURE Thicken liquids Thicken purees AVOID MIXED TEXTURES Gradual progressions

Cup Drinkingtypical 10-month old versus 1-year old with delay : Cup Drinkingtypical 10-month old versus 1-year old with delay

Thickening Purees : Thickening Purees Heavy work Gritty/smooth High/low calorie High/low fiber Food composition Family preference Cost

Solids- Gradual Progressions : Solids- Gradual Progressions Beyond baby foods Crunch & crumble foods Jump start feeding

Easy-to-Eat Foods : Easy-to-Eat Foods Finger Foods -easier to hold -tactile experience -independence

Engage Child(language, activities) : Engage Child(language, activities) Model Animated, upbeat directives “Can do” language Control ..predictability

Resources : Resources Visit http://www.efslibrary.net/ to learn more about on-line learning and the Nutrition Certificate for Optimal Health, Wellness and Sport. See following slides for more details. Visit www.superkidsnutrition.com for expert nutrition articles, kids activities, books and resources to grow healthy family and communities. Visit www.lindapiette.net to learn more about Linda’s book Just Two More Bites.

Who Should Attend the Online Professional Certificate in Nutrition for Optimal Health, Wellness, and Sports : Who Should Attend the Online Professional Certificate in Nutrition for Optimal Health, Wellness, and Sports Individual consumers interested in learning more about nutrition, daily meal planning, wellness strategies, and sport nutrition and performance will be introduced to information to help them achieve their own goals or for their family members. Content and curriculum in each course is designed to prepare allied health care professionals and Registered Dietitians to apply their client’s health history toward optimal nutritional health and wellbeing. Personal trainers and fitness professionals will learn fundamental nutrition education to work with clients in partnership with Registered Dietitians. The Commission on Dietetic Registration (CDR), the credentialing agency for the American Dietetic Association (ADA) has approved the Certificate in Nutrition program for 120 Continuing Professional Education Units (CPEUs) or 30 (CPEUs) per course for both the Registered Dietitian (RDs) and Dietetic Technician-Registered (DTRs).

CPE Instructions for RDs : CPE Instructions for RDs Following the event, you’ll need to immediately email LADWebinar@gmail.com To receive your 1 hour CPE unit you will need to email LADWebinar@gmail.com This is not a contact email, so no other questions should be sent here. You will receive a certificate by the following day.

Registration Dates : Registration Dates For Dietitians attending: Following the event, you’ll need to immediately email LADWebinar@gmail.com Learn more about the program and locate the school http://www.efslibrary.net/ Module 1: Feb. 9 – Mar. 15 (Registration Deadline 2/10) Course 1: Nutrition and You: Functional Foods Course 2: Weight Management and Nutrition Module 2: Mar. 16 – Apr. 19 (Registration Deadline 3/19) Course 3: Introduction to Sports Nutrition and Performance Course 4: Public Nutrition and Wellness Education *Modules Do not have to be taken in order