Chapter Five: Chapter Five: Promoting Good Nutrition Promoting Good Nutrition

In Child CareIn Child Care

Nutrition PoliciesNutrition Policies

Need for policies Centers are doing a poor job of

providing nutrition Inadequate calories, iron, niacin, and zinc

— too much fat 90% of CACFP centers studied fell short

of meeting needs Low degree of staff knowledge has a

direct effect on nutrition

13 million children in child care get a significant part of their weekday nutrition from there

For children in care all day, 2 of 3 meals are eaten in care

Parents should consider nutritional program of a center when choosing child care

Major Goals for Nutrition Policies Maximizing Nutritional Status Minimizing Nutritional Risk Using Nutritional Education as a Tool Recognizing Importance of Nutritional

Guidelines

Policies NeededPolicies Needed

Nutritional Guidelines Basic Nutrition (Understanding) Nutritional Challenges Methods and Practices for Caregivers

Understanding Nutritional Understanding Nutritional GuidelinesGuidelines

Dietary Guidelines for Americans Aim for Fitness

Aim for a healthy weight Be physically active

Build a healthy base Let the Pyramid guide your food choices Eat a variety grains daily, especially whole

grains Eat a variety of Fruits and Vegetables daily Keep food safe

Dietary Guidelines for Americans (cont’d.) Choose sensibly

Choose a diet that is low in saturated fat and cholesterol and moderate in total fat

Choose beverages and foods to moderate your intake of sugar

Choose and prepare foods with less salt

Food Guide PyramidFood Guide Pyramid

Level One 6-11 servings; breads, cereals, rice, and pasta

Level Two 3-5 servings; vegetables; 2-4 servings fruits

Five A Day Campaign Level Three 2-3 servings; milk, yogurt and

cheese Level Four Fats, oils, and sweets sparingly

Reference Daily Intake Food Label (see Figure 5-2)

Calories, fat, cholesterol, carbohydrates, protein, Vitamin A, Vitamin B, Vitamin C, calcium, and iron are listed

Healthy People 2010

Child and Adult Care Food Program

Energy Nutrients (Macronutrients) Provide calories

Fats, 9 grams Proteins and Carbohydrates, 4 grams

Include Carbohydrates Fats Proteins

Basic NutrientsBasic Nutrients

Helper Nutrients (Micronutrients) Vitamins Minerals Water

Energy NutrientsEnergy Nutrients

Carbohydrates First source of energy for the body Major source of energy for central nervous

system Provide glucose to liver to store for energy Found in Level One and Level Two foods Diet should consist of 58% carbohydrates Too little causes body to use up fat and

protein

Fats Second source of energy Supplies essential fatty acids for child’s growth Cushions organs, maintains body temperature,

promotes healthy skin, helps carry fat-soluble vitamins, and regulates cholesterol metabolism

Major source—Level Three and Level Four foods

Diet should consist of 30% fats

Types of Fats Saturated raises cholesterol found in

animal fats Monounsaturated is neutral found in

olives, peanuts, nuts, and avocados Polyunsaturated lowers cholesterol

found in plants and plant oils RDA recommends 10% from each category

Adequate fat is necessary

Protein Third source of energy Major building block in our bodies, in every cell Builds new cells, aids in repairing damaged

tissue, forms enzymes for digestion, and provides hormones and antibodies that help resist infection

Comes from Level One and Level Three foods

Made of amino acids

Nine are essential

Complete proteins have all nine

Complete proteins come from animal sources

Incomplete proteins have some but not all

nine essential amino acids

Foods must be combined properly to provide

complete protein

Helper NutrientsHelper Nutrients

Vitamins assist energy nutrients and aid in metabolism Fat Soluble

Vitamin A, Vitamin D, Vitamin E, and

Vitamin K Water Soluble

Vitamin B and Vitamin C

Vitamin A Promotes growth, good vision, bones, and skin, and

helps heal wounds Sources are yellow, orange and green fruits, and

vegetables Considered an antioxidant

Vitamin D Needed to help calcium make strong bones and teeth Produced naturally in the skin Sources are sunshine and is added to milk, found in

fatty fish, liver, eggs, and butter

Fat Soluble VitaminsFat Soluble Vitamins

Vitamin EHelps preserve cell tissuesProtects red blood cells and lungs Is an antioxidantSources are whole grains and vegetable

oils

Vitamin KNeeded for normal blood clottingSources are dark green leafy vegetables

and whole grains

Water Soluble VitaminsWater Soluble Vitamins

Vitamin BThiamin essential for carbohydrate

metabolism and functioning of nervous system

Niacin essential for carbohydrate metabolism, fat synthesis, and tissue respiration

4 Ds

Vitamin B (cont’d.)Riboflavin essential for carbohydrate,

fat and protein metabolism; promotes healthy skin, eyes, and clear vision

Folacin required for normal growth; prevents anemia and is important in reproduction

Overall sources are grains, green leafy vegetables, meats, nuts, and milk products

Vitamin C Is an antioxidant

Helps fight disease and protect against free radicals

Assists with formation and maintenance of collagen

Helps to heal wounds and maintain healthy blood vessels

Stimulates immune system to prevent infectionSources are citrus fruits, cabbage, kales,

broccoli, bell peppers, black currants, and turnip greens

Minerals help metabolism and regulate body fluids

Calcium present in all bones and teeth Regulates body systems, promotes nerve

transmission and functions in muscle contraction

Major source is milk and milk products

Minerals Minerals

Phosphorus present in all bones and teeth Transports fat and provides enzymes for energy

metabolism Sources are milk products, meat, poultry, fish,

and whole grains

Iron combines with protein to form red blood cells and carry oxygen

Helps immune system resist infection and enzymes to release energy to body

Sources are milk, meat, leafy green vegetables, and whole grains

Sodium important for fluid balance in body Contributes to nerve stimulation and muscle

contraction Sources are salt, baking soda, celery, milk, eggs,

poultry, and fish

Magnesium present in bones and teeth Transmits nerve impulses, aids enzymes for

energy metabolism, helps muscle contraction Sources are milk, meat, green leafy vegetables,

whole grains, and legumes

Potassium important for protein and carbohydrate metabolism

Helps in water balance and transmits nerve impulses

Sources are vegetables, fruit juices, and fruits, especially bananas and tomatoes

Fluoride promotes strength of bone and teeth structure

Prevents tooth decay Sources are fish and fluoridated water Fluoride controversy

WaterWater

Water necessary to sustain life 70% of human body is water Needed for metabolic activity within cells,

transportation of nutrients and waste products Water loss in body due to urination and evaporation

Dehydration can be a major problem for infants and young children

Sources are most foods found in nature and water Fruits and vegetables are a major source

Childhood Nutritional Childhood Nutritional ChallengesChallenges

Nutritional challenges can be related to malnutrition or overnutrition

Hunger, Malnutrition, and Their Effects Hunger = chronic shortage of nutrients 12 million children experience it in U.S. Causes

Stunting Impaired brain functions Vulnerability to infection and disease

Children with chronic health conditions may be at increased risk for hunger and growth retardation

Parents and caregivers may lack

Knowledge of nutritionTimeAbility to prepare nutritious meals

Prevention strategiesNutrition educationA balanced diet of healthy foodsHealthy food-preparation methods

Obesity Most prevalent nutritional disease of

children under age 18 years Excess weight caused by energy imbalance

20% over norm weight May be ethnically linked Hispanic, African

American, and Native American children have a higher rate of obesity

Some common reasons for obesity Dietary excess in fats and sugars Lack of exercise Too much TV Poor infant/child feeding practices Food as comfort Genetic predisposition

Dental Caries (Cavities) Foods high in carbohydrates and sugar

promote formation of cavities Fluoride most effective way of preventing

cavities Brushing teeth after meals and not giving

juice in bottles help in prevention

Iron Deficiency Anemia Most prevalent nutritional problem in children in U.S. Twice as likely to occur in poor families Children may have trouble concentrating, which may

affect brain development Diets need sufficient amounts of iron to prevent it Infants need vitamin supplements Menus at child care need to be checked for adequate

iron

Cardiovascular Disease and Hypertension Too many calories, too much fat, and too much

cholesterol Can lead to development of coronary atherosclerosis

or heart disease Excess sodium and weight can lead to hypertension Best way to improve risk is to modify child’s diet Should eat diet high in carbohydrates

Food Allergies Foods that commonly bring on allergies are

milk, peanuts, oranges, wheat, pork, and eggs

Education Role Modeling Supervision

Implications for CaregiversImplications for Caregivers

Important to child care for 3 reasons Most common food allergy (28% over 1

year, 46% under 1 year) Child care often relies on peanut butter and

peanut products as a cheap source of protein for snacks and lunches

Peanut allergy increasing in frequency

Reality Check: Peanut Reality Check: Peanut AllergyAllergy

Symptoms more severe than all other food allergies More emergency rooms visits More likely to cause death than many food

allergies• Often unable to breathe

Make sure parents are asked about this when entering child in child care

Make a careful plan for preventing exposure Should it occur, have a plan how to deal with it

(see pages 189-190)