© 2006 thomson-wadsworth chapter 11 children and adolescents: nutrition issues, services, and...
TRANSCRIPT
© 2006 Thomson-Wadsworth
Chapter 11
Children and Adolescents: Nutrition Issues, Services, and
Programs
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Learning Objectives
• Describe three nutritional problems currently experienced by U.S. children and adolescents.
• Specify four Healthy People 2010 nutrition objectives for children and adolescents.
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Learning Objectives
• Discuss four nutrition assistance programs aimed at improving the health and nutritional status of children, including their purposes and types of assistance offered.
• Describe factors that increase the likelihood of obesity in children.
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Introduction
• Rates of childhood morbidity and mortality due to infectious diseases have dramatically decreased, but new perils have arisen in the past few decades.
• There has been an alarming increase in the prevalence of overweight and obese children and adolescents.
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Introduction
• Children are generally categorized as ages 1 to 11 years, while adolescents are ages 12 to 19 years.
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Healthy People 2010 National Nutrition Objectives
• Priority concerns for children and adolescents in Healthy People 2010:– Physical activity and fitness– Nutrition– Dental health
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Healthy People 2010 National Nutrition Objectives
• Healthy People 2010 Progress Review– The progress review of Healthy
People 2010 suggests that significant steps be made in order to bring about further progress toward achievement of the objectives that promote healthy weights and food choices in children and adolescents.
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What Are Children and Adolescents Eating?
• Children’s eating habits have changed over the past two decades.
• The Healthy Eating Index (HEI), used as an indicator of diet quality, provides an overall picture of the variety and quantity of foods people choose to eat, and their compliance with specific dietary recommendations.
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What Are Children and Adolescents Eating?
• HEI findings:– Children ages 7 to 9 have a lower diet
quality than younger children.– Most children do not meet
recommended intakes of vegetables or meat.
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What Are Children and Adolescents Eating?
• The Continuing Survey of Food Intakes by Individuals (CSFII) results indicate that children of all ages, races, and ethnic groups were at risk of inadequate intakes of: – Magnesium– Zinc– Vitamins A and E
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What Are Children and Adolescents Eating?
• Influences on Child and Adolescent Eating Patterns and Behaviors
• Weighing In on the Problem of Childhood Obesity– Over the past two decades, the
percentage of children who are overweight has nearly doubled and the percentage of adolescents who are overweight has almost tripled.
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What Are Children and Adolescents Eating? – Obesity
• Childhood Obesity and the Early Development of Chronic Diseases. – Childhood obesity is associated with
hyperinsulinemia, hypertriglyceridemia, and reduced HDL-cholesterol concentrations.
– Contributing factors include:• Genetic susceptibility to obesity• Lifestyle• Family eating patterns• Lack of positive role models• Inactivity
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What Are Children and Adolescents Eating?
• Other Nutrition-Related Problems of Children and Adolescents– Undernutrition
• Undernutrition is a problem for children from low-income families and those who have run away from home or abuse alcohol or drugs.
• The common and widespread practice of dieting among adolescents, especially girls, makes them at risk for undernutrition.
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What Are Children and Adolescents Eating? – Other Problems
• Iron Deficiency and Iron-Deficiency Anemia– One of the most common nutritional
deficiencies, not only in the United States, but in the world.
• Blood Lead Level– Overall, the percentage of children aged 1
to 5 years with elevated blood lead levels decreased more than 80% between 1976 and 1994.
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What Are Children and Adolescents Eating? – Other Problems
• Dental Caries– Although dental caries are largely
preventable, it remains the most common chronic disease of children aged 5 to 17 years.
• High Blood Cholesterol– When compared with children in other
countries, children and adolescents in the United States have higher blood cholesterol levels and higher dietary intake of saturated fat and cholesterol.
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What Are Children and Adolescents Eating? – Other Problems
• Eating Disorders– Anorexia nervosa and bulimia
nervosa may affect about 3% of all teenage girls in the U.S.
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What Are Children and Adolescents Eating?
• Children with Special Health Care Needs– Children with special health care
needs include those with: • Developmental disabilities• Developmental social needs• Handicapping conditions• Chronic disorders• Chronic illnesses
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What Are Children and Adolescents Eating? – Special Needs
• These children are at increased nutritional risk because of factors such as: – Feeding problems– Metabolic aberrations– Decreased mobility– Alternations in growth patterns
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What Are Children and Adolescents Eating?
• Despite the importance of healthful eating habits, unhealthful eating patterns are becoming more pronounced due to: – Increased independence from parents– Eating away from home– Concern with physical appearance and body
weight– The need for peer acceptance– Busy schedules
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Nutrition Education Strategies for Preadolescent Girls
• “Free to Be Me” – A Girl Scout badge program that
helps young girls feel good about their bodies.
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Nutrition Education Strategies for Preadolescent Girls
• Goals and Objectives– Goal:
• Assess the feasibility and short-term impact of “Free to Be Me”
– Objectives:• Decrease incidence of unhealthful weight control
behaviors• Increase knowledge of media influences on body image
and food choices• Increase the interest in healthful eating and body image• Improve participants’ ability to critically evaluate media
messages• Improve overall body image
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Nutrition Education Strategies for Preadolescent Girls
• Methodology– 6 90-minute sessions presented
during consecutive bi-weekly Girl Scout meetings
– Activities on: • Body development• Media’s impact on body image and self-
esteem• Combating negative images
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Nutrition Education Strategies for Preadolescent Girls
• Methodology (continued)– 3-hour training session taught troop
leaders to teach the program– Parental involvement:
• Receiving weekly mailings• Assisting with take-home activities• Preparing healthful snacks• Viewing end-of-session skits
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Nutrition Education Strategies for Preadolescent Girls
• Results– Group-randomized, controlled study
was designed to evaluate program effectiveness • 12 troops that participated in “Free to Be
Me” • 13 non-participating troops as controls
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Nutrition Education Strategies for Preadolescent Girls
• Results (continued)– Had a significant influence on media-
related attitudes and behaviors– Modest program impact on body-
related knowledge and attitudes– Apparent immediately after the
intervention, but not at follow-up– Significant changes were not noted
for dieting behaviors
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Nutrition Education Strategies for Preadolescent Girls
• Lessons Learned– Community nutrition programs may
be successfully implemented within Girl Scout troops.
– Intervention programs for young adolescent girls have the potential to promote a positive body image and prevent unhealthful dieting behaviors.
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The History of Child Nutrition Programs in Schools
• Federal programs addressing the nutritional needs of children and adolescents have existed for more than 150 years.
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Nutrition Programs of the U.S. Department of Agriculture
• The National School Lunch Program– Helps states make lunches available to
children and encourages consumption of domestic agricultural commodities.
– Lunches must include the following:• 8 ounces fluid milk• 2 ounces protein• ¾ cup serving consisting of two or more
vegetables or fruits or both• 8 servings of bread, pasta, or grains per week
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Nutrition Programs of the U.S. Department of Agriculture
• The School Breakfast Program– Helps states provide a nutritious, nonprofit
breakfast for children.– Breakfast must provide one-fourth of the
daily recommended levels of protein, calcium, iron, vitamin A, vitamin C, and calories.
– Breakfast can be either hot or cold.– Breakfast is served free or at a reduced
price to eligible students.
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Nutrition Programs of the U.S. Department of Agriculture
• The After School Snack Program– This expansion of the NSLP provides
reimbursement for snacks served to children, through the age of 18, in after school educational and enrichment programs.
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Nutrition Programs of the U.S. Department of Agriculture
• The Summer Food Service Program for Children– Provides funds for eligible sponsoring
organizations for the purpose of serving nutritious meals to needy children when school is not in session.
– Sponsoring organizations include:• Residential camps• Youth sports camps• Units of local, county, tribal, or state government
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Nutrition Programs of the U.S. Department of Agriculture
• The Food Distribution Program– Provides commodities to public and
private nonprofit schools that serve meals to students.
– School districts are given an entitlement dollar value based on the number of lunches served during the previous year.
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Nutrition Programs of the U.S. Department of Health and Human Services: Head Start
• Head Start provides children form low-income families with comprehensive social, education, health, and nutrition services.
• Eligible children range in age from birth to the age at which they begin school.
• It provides meals and snacks as well as nutrition assessment and education for children and their parents.
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Impact of Child Nutrition Programs on Children’s Diets• Despite progress that has
enhanced the nutrition quality of school meals, results of research conducted in the 1990s indicated that school meals were failing to meet certain key nutritional goals.
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Impact of Child Nutrition Programs on Children’s Diets• Factors Discouraging Participation in
Child Nutrition Programs– The environment in some schools
discourages students from eating meals provided by the NSLP and SBP...
– ...and encourages food choices and eating habits that are not consistent with the Dietary Guidelines for Americans, such as purchase from competitive foods from vending machines
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Impact of Child Nutrition Programs on Children’s Diets• Building Healthful School
Environments– Many states and school districts are
developing policies that limit the sale of competitive foods and less healthy food choices.
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Action for Healthy Kids
• Action for Healthy Kids (AFHK) - an integrated, national–state initiative that addresses childhood obesity by focusing on changes in the school environment– Leadership provided by former Surgeon
General David Satcher– Includes a partnership of 40 national
organizations, industry groups and government agencies representing education, physical activity, and health and nutrition
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Action for Healthy Kids
• Goals– Short term - increase the number of health-
promoting schools that support sound nutrition and physical activity in order to slow the rate of increasing overweight among American children
– Long term - play a key role in preventing childhood overweight nationwide
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Action for Healthy Kids
• Objectives– Improving schoolchildren’s eating
habits by: • Increasing access to nutritious food and
beverages on school grounds• Decreasing access to high-calorie, low-
nutrient options• Integrating nutrition education into the
curriculum for all schoolchildren
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Action for Healthy Kids
• Objectives (continued)– Increasing schoolchildren’s physical activity
through: • Physical education courses• Recess• Integration of physical activity into academic
classes• After school and co-curricular fitness programs
– Educating administrators, educators, students, and parents about the role of sound nutrition and physical activity in academic achievement
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Empowering Teens to Make Better Nutrition Decisions
• “Food on the Run” – Recognized the importance of
empowering teens to make better decisions about their diet, activity, and health.
– Collaboration among 10 California communities
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Empowering Teens to Make Better Nutrition Decisions
• Goals and Objectives– Goal: Improve the health of high
school students through: • Promotion of accurate nutrition
information in the classroom • Increased availability of healthful food
options on campus
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Empowering Teens to Make Better Nutrition Decisions
• Goals and Objectives (continued)– Objectives:
• To create a high school youth advocacy model that motivates students to advocate for more healthful food and physical activity options in their communities.
• To advance locally identified policy and environmental changes that increase the number and promotion of healthful food items and physical activity options on participating school campuses.
• To motivate students to make more healthful food choices and to become physically active.
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Empowering Teens to Make Better Nutrition Decisions
• Target Audience– Low-income students in high schools
where at least 40% of the students were eligible for free/reduced-price meals
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Empowering Teens to Make Better Nutrition Decisions
• Rationale for the Intervention– Spectrum of prevention framework – States that the following components are
necessary to effect change at the individual and community levels:
• Strengthening individual knowledge and skills• Promoting community education• Educating providers• Fostering coalitions and networks• Changing organizational practices• Influencing policy and legislation
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Empowering Teens to Make Better Nutrition Decisions
• Methodology– Each school worked with a coalition of local
organizers, health providers, and private industry to build its program
– Components:• Recruitment and training of 10–20 high school
student advocates• Implementation of at least 7 school-based
activities• At least 2 activities to increase parent awareness
and involvement
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Empowering Teens to Make Better Nutrition Decisions
• Results– Student surveys and an assessment of the
school environment– Statistically significant increases observed
for: • Physical activity knowledge and attitude • Nutrition knowledge, attitude, and behavior• Healthy eating options • Healthy eating promotional efforts on school
campuses • Physical activity options available to students at
the schools
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Empowering Teens to Make Better Nutrition Decisions
• Lessons Learned– Student involvement is the key to
offering healthful foods that sell and physical activity classes that are full.
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Nutrition Education Programs
• Nutrition education strategies aimed at children or their caregivers are found in both the public and private sectors, and strive to improve eating patterns among children.
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Nutrition Education Programs
• Nutrition Education in the Public Sector– Three nutrition education
programming agencies have been the USDA’s: • Nutrition Education and Training program
(NET) – not reauthorized in 2004• Expanded Food and Nutrition
Education Program (EFNEP)• TEAM Nutrition
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Nutrition Education Programs – Public Sector
• The CDC Coordinated School Health Program (CSHP) combines health education and promotion, disease prevention, and access to health and social services in an integrated, comprehensive manner.
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Nutrition Education Programs – Public Sector
• YourSELF
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Nutrition education activity from USDA’s YourSELF program (7th and 8th grades)
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Nutrition Education Programs – Public Sector
• Eat Smart. Play Hard.• 5 a Day the Color Way• VERB. It’s What You Do• Powerful Bones, Powerful Girls
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Nutrition Education Programs
• Nutrition Education in the Private Sector
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Nutrition Education Programs
• Keeping Children and Adolescents Healthy– Programs and services designed to keep
children and adolescents healthy can have a lasting effect on the nation’s public health.
– Programming for children and adolescents succeeds when it is fun and informative and when it is geared toward a specific health or nutritional objective, such as weight loss or increased physical activity.
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Nutrition Education Programs
• Keeping Children and Adolescents Healthy (continued)– Involving children and adolescents in
the planning and implementation of a program increases its effectiveness, as does using peer support.