fitCare Best Practice Curriculum Facilitation Outline Class #3

fitCare, written by Sanford Health. Permission given to the State of South Dakota to use for the fitCare Best Practice collaboration project between the South Dakota Department of Health, the South Dakota Department of Social Services Division of Child Care Services, Sanford Children’s and the Sanford fit Initiative. ©2011; Revised 2014. Revised ©2015 Sanford Health. All rights reserved. sanfordfit.org

fitCare Best Practices Think Your FOOD

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fitCare Best Practice Curriculum Facilitation Outline Class #3

Think Your

FOOD



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fitCare Best Practice Curriculum Class #3

Think Your FOOD

Course Goal:

Child caregivers will have knowledge and tools to provide an environment that promote healthy lifestyle habits for children in their care.

Increase caregiver understanding of: 1. Healthy FOOD and drink choices for children.

a. Supporting breastfed infants 2. The importance of encouraging children to eat fruits and vegetables. 3. The importance of decreasing children’s consumption of sweetened beverages. 4. Correct FOOD and drink portion sizes for children. 5. Children’s ability to read body cues of being hungry and full. 6. How the body needs FOOD for fuel versus FOOD to manage feelings. 7. How media influences children’s FOOD and drink choices. 8. Ways child caregivers can help children learn about healthy FOOD choices through child care

program/schedule planning. 9. Best practices relevant to helping children learn about and implement healthy FOOD choices while in child

care. 10. The importance of a child care program having a policy that encourages and supports children’s healthy eating

choices and habits. Increase caregiver ability to: 1. Teach and encourage children to eat fruits and vegetables. 2. Teach and encourage children to drink water and milk and decrease consumption of sweetened beverages. 3. Teach and encourage children to be aware of body cues related to feeling hungry and full. 4. Teach and encourage children to make healthy FOOD choices. 5. Teach and encourage children to be aware of marketer’s influence on their FOOD and drink choices. 6. Teach and encourage children to talk themselves into making healthy FOOD choices. 7. Educate parents on the importance of children being taught about and practicing healthy FOOD choices at

home. 8. Facilitate best practices to ensure children are encouraged and able to make healthy FOOD choices during

their time at child care.



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Think Your FOOD

Class Material List

Instructor Child Caregiver Child Parent

FOOD Pre Class Questionnaire X FOOD Post Class Questionnaire X FOOD Self-Assessment Tool X fit One Thing I Will Do…Card X Portion Control Quiz X Sugary Drink Quiz X Food Media Mania Quiz X Better Choices Game Board X Green Plate Food Cards

X

Yellow Plate Food Cards

X Red Plate Food Cards

X

Green Plate X Red Plate X Screen Time Game - TV

TV Food Pictures

X X

Spoonful of Sugar Parent Poster X More for Less is Not Always a Good Deal Poster X FOOD Activity Guide X Award Ribbons – I ate a NEW fruit today! X X Award Ribbons – I ate veggies today! X X I Want to be a Healthy Kid (FOOD) X X Healthy Food Hunt X X X I Ate Healthy Foods Chart X X X 2-3 Year old Food Guide X 4-8 Year old Food Guide X



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Pre-Class Questionnaire (Optional)

Used to track class knowledge gain and participants’ intent to put knowledge into practice

1. Have class participants complete fitCare Pre-Class Questionnaire.

2. Collect fitCare Pre-Class Questionnaire. 3. Submit fitCare Pre-Class Questionnaire to data collection office or designated personnel.

Introduction of Course Why fitCare classes matter

• Why am I here? o To learn how to provide an environment that promotes healthy lifestyle habits for

children in my care. o To learn about ways to help kids learn about and develop healthy lifestyle habits.

Brief Review of the Pediatric Obesity Issue • Review obesity epidemic.

o Refer to pages 12-16 of the “Be fit …RECHARGE Your Energy” class outline o Extent of review may vary based on class participants’ need for review

• We have a problem; current pediatric obesity epidemic. o The problem: 1 in 5 (approximately 23 percent) two to five year olds are overweight or

obese. Source: https://healthykidshealthyfuture.org/5-healthy-goals

Facilitation/Instruction Outline



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o The problem: An overweight 3-year-old child is nearly 8 times as likely to become an overweight young adult compared to a non-overweight developing 3-year-old. Source: Zero to Three

• Childhood obesity is a national issue and a local issue – YOU can help.

• Impact: o Emotional Health

o Physical health

o Childhood obesity is associated with various health-related consequences. Heart disease, caused by:

* high cholesterol and/or * high blood pressure

Type 2 diabetes Asthma Sleep apnea

o Overweight and obese children and adolescents May experience immediate health consequences. May be at risk for weight-related health problems in adulthood.

• You can help fix the problem.

o In 2012, nearly 11 million children under age 5 in the United States were in some type of child care arrangement every week. Source: www.naccrra.org

o On average, the children of working mothers spend 35 hours a week in child care. Source: www.naccrra.org

• You o Touch children’s lives every day. o Are in a place of influence.



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o In center and home-based childcare settings, teachers, and family child care providers influence children’s eating behaviors by the foods they offer, the behaviors they model, and their social interactions with children at snack and mealtimes. Source: NAEYC Young Children (March 2011) - The Impact of Teachers and Families on Young Children’s Eating Behaviors

• Where to start: o Provide information to children and parents regarding fit o Practice fitCare best practices in child care

What is fitCare?

• fitCare is a program to help child care providers combat the pediatric obesity epidemic. o It focuses on teaching children how to make healthy food and move choices.

• When caregivers implement the fitCare program, they use fit principles to:

o Teach children o Educate parents o Role model behavior o Implement best practices

• fitCare provides child caregivers with fit knowledge and tools to teach others about fit.

o Why being fit matters o What it is to be fit o How to be fit



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What is fit?

• fit is a behavior theory. o Combines behavior change and choice theories o Brings a conscious awareness of why, what, and how we make healthy lifestyle choices

(food and physical activity choices)

o Acknowledges the importance of emotions and energy in the decision making process What to eat To move or not move

• fit connects four key factors to having a healthy body and weight o MOOD – Motivate Your MOOD o RECHARGE – RECHARGE Your Energy o FOOD – Think Your FOOD o MOVE – MOVE your Body

• What is fit? o fit recognizes that our MOOD and RECHARGE influence our FOOD and MOVE

choices Influencers Emotions and Attitudes – MOOD Rest and Energy levels – RECHARGE

Choices Nutritional choices – FOOD Physical activity choices – MOVE

• Being fit is not just about: o What to eat and drink

or o How you move



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• Being fit is about o Having the right mindset and enough energy

to be able to choose o Healthy foods and to be active

• fit is about o Having the energy (RECHARGE) and motivation (MOOD) to make healthy choices Eat and drink healthy FOODs MOVE your body

fit and FOOD

• We make FOOD choices every day.

• Some of our choices are healthy for us; some are not. o FOOD choices matter o Learn to Think Your Food

• FOOD is fuel for our body and brain. o What we eat and drink

• FOOD gives o Our body energy to MOVE. o Our brain energy to think. o Us energy to live.

• Being fit is thinking about o What to eat and o Why we eat

…when making a FOOD choice



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• Think Your FOOD o Is this food healthy for my body? o Is this food healthy for my brain? o Am I really hungry or just bored? o Am I eating too much of this food? (i.e. candy) o Am I eating too little of this food? (i.e. vegetables)

• FOOD’s connection to the fit factors o MOVE: FOOD gives us energy to be physically active

• fit recognizes that our MOOD and RECHARGE influence our FOOD choices. o Influencers Emotions and Attitudes – MOOD Rest and Energy levels – RECHARGE

o Choices Nutritional choices – FOOD

o RECHARGE: FOOD choices are impacted by our sleep and rest behaviors

When the body craves sleep, the brain can miscue you to think you are hungry Lack of sleep disrupts hormones that play a role in body weight regulation and

appetite stimulation This disruption in hormones triggers overeating and may also signal the body

to cling to fat stores more tenaciously * Ghrelin (Pronunciation: GREL-in) spikes (increases appetite)

A hormone that signals hunger to the brain; an appetite increaser * Leptin crashes (decreases awareness of being full)

A hormone that regulates the amount of fat stored in the body; signals satiety

o MOOD: FOOD choices are impacted by our emotional state of mind (MOOD) at the moment of our choice



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o MOOD impacts FOOD choices Emotional Eating Eat due to feelings, not due to hunger

Mindless Eating Eating while doing something else – i.e., watching TV Not aware of what we are eating or how much we are eating

• Emotional Eating: impact on eating habits o Your emotional state influences why, what, and when you eat. o Eating to feed a feeling: When you quench feelings with comfort food and your stomach isn't growling When you're sad, you eat ice cream or cookies When you're bored, you eat potato chips

• Emotional eating can lead to overeating, because it usually isn’t about fulfilling a need for

nutrients or calories.

• Negative emotional states can lead to unhealthy FOOD choices. o Research has shown that when we are sad, mad, upset, tired, or angry our FOOD

choices have a tendency to be unhealthier than they would be if we were in a positive emotional state (MOOD) and well-rested (RECHARGE). Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859040/

o Emotional eating can be learned early by well-meaning parents and caregivers. If parents respond to their infant’s emotional needs (MOOD) by feeding the infant,

the infant will confuse hunger with fulfilling emotional needs and will learn to eat when sad, lonely, frustrated, or angry (MOOD). Source: Zero to Three

o Emotional eating often starts early in life and becomes a habit that stays with us into

our adult years. Children are like adults – they may eat as a response to their emotional states

versus actually being hungry. Some emotions associated with emotional eating include: Boredom Stress Sad Mad Tired



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o We inadvertently teach children emotional eating. It is common for FOOD to be used as A reward for good behavior. A bribe to motivate a child’s behavior (be good and you get a treat)

FOOD should not be used as a reward for good behavior. This practice encourages emotional eating and emphasizes that FOOD is a

“prize” versus fuel for our bodies.

• What is food to you?

o A means to feel better? o A reward or treat? o Do you Think Your FOOD choices?

• Do you think your FOOD? o Practice mindful eating habits. Mindful eating is being aware of why, what, and how much you are eating, and Being in charge of your food choices.

o Researchers have found that mindfulness and intuitive eating is more effective than

traditional weight-loss programs. Source: Published in the American Journal of Health Promotion: http://ajhpcontents.org/doi/abs/10.4278/ajhp.120404-QUAN-186

• Mindless eating easily happens by

o Being unaware of why, what, and how much you are eating.

• Mindless eating can easily occur when watching television or playing computer games. o It is easy to overeat while watching TV or playing computer games.

o Children who eat while watching TV or playing computer games have little or no

awareness of how much they are eating (mindless eating).

• Children spending time in front of a screen are more at risk for: o Mindless eating o Emotional eating

http://ajhpcontents.org/doi/abs/10.4278/ajhp.120404-QUAN-186



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Think Your FOOD

• Learn to Think Your FOOD.

• What to think about…consider these:

o Portion sizes: We are eating too much. We are taking in more fuel than our body can use and the

excess fuel is stored as fat.

Portion sizes have doubled since 1970.

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447051/ The average restaurant meal today is more than four times larger than in the

1950s. Source: CPPW_TheNewAbnormal_Custom 5-18-2012.pdf * Examples:

1. Super-Sized meals 2. Larger bottles of soft drinks 3. Large cookies

o How much are you eating…do you know?

Portion Control Quiz 1. Ask participants if they think they know food serving sizes for

themselves. 2. Have participants complete the Portion Control Quiz during class. 3. After completion, ask participants what they believe is the right

answer. 4. Using the answer sheet, discuss the correct answers.

Closing Point(s): • Know your portion sizes • Know children’s portion sizes • Children sized portions of food and drink are not the same as adults • Know what children should eat or drink for their age



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Don’t overfeed children. Children are not always served child sized portions but are served adult sized

portions. Children do not need as much as to eat and drink We are teaching children to overeat by serving them adult serving size portions

o Vegetable and fruit consumption is too low. Need for more vegetables and fruits Vitamins and minerals Fiber Naturally low in calories Quick, natural snack

Why fruits and vegetables are so important Vegetables give children vitamins and minerals that keep them healthy and

help them grow Fruits and vegetables are “nutrient dense” – lots of nutrients but few calories

unless too much butter, cheese, or meat fat is added Fruits and veggies are nutritious and delicious

All forms count Fresh, frozen, canned and dried. It’s all good! FOODs processed within hours of harvest keep flavor and nutritional value Canned FOODs are recipe ready Frozen FOODs require little preparation

o Consumption of sweetened beverages is too high No nutritional value and high calories in sweetened beverages Too much pop is being consumed Children are being served too many sweetened juices with added sugar 70% of children ages 2-5 years old consume at least one sugary drink a day.

Source: http://www.cdc.gov/nchs/data/databriefs/db71.pdf

Sugary Drink Quiz

1. Distribute the Sugary Drinks Quiz to each participant. 2. Give participants time to complete. 3. Use the answer sheet to discuss the correct answers.

o Were they shocked with the results? o What surprising to learn? o What was not surprising to learn?

Closing Point(s): • Sweetened beverages contain a lot of sugar with little nutrition value • Limit children’s sweetened beverage intake



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Food Media Mania

1. Distribute a quiz to each participant 2. Give participants five minutes to complete 3. Use the answer sheet to discuss the correct answers.

o Were the participants shocked with the results? o What surprised the participants? o What didn’t surprise the participants?

Closing Point(s): • Marketers use media such as television to influence children to want their food

products. • Being aware of this negative influence helps one not to “buy into” the messages that

can encourage an individual to make poor food choices relevant to healthy lifestyle habits.

• Marketers spend a lot of money to influence children so children will influence their parents (the “nag or pester” influence).

• We have work to do and habits to change. We are o Eating too much. o Not eating enough fruits and vegetables. o Drinking too much sugar.

• How did we develop these habits? o Over time, daily choices develop into habits and become Automatic patterns of thought.

• Our FOOD choices are being influenced by external influencers. o Who is influencing our FOOD choices that become habits? o How are we being influenced?

Key FOOD influencers to consider

• Marketers influence our FOOD choices. o Marketers have led us to believe we need sweet FOOD, large portions, fried foods, etc. Marketers take advantage of on our emotional eating tendencies Marketers play to our emotional states (MOOD) to influence our FOOD choices

• What do you know about marketer messages?



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• Consider who is telling children what to eat. o Marketer influence on unhealthy FOOD choices Too many child targeted commercials promote high-sugar and/or high-fat FOODs.

• Screen time influence on eating

o Children who spend time in front of a screen have a greater tendency to eat the advertised, high-sugar FOOD.

o A 2009 study found that on the average, 5.2 food advertisements were presented every hour during Saturday mornings and weekday afternoons. 12 networks were part of the study including:

Highly rated children's cable channels Nickelodeon, Cartoon Network, and Kids' WB

Networks that appeal to older youths (MTV, BET), mainstream English-language channels ABC, CBS, NBC, FOX, and UPN

Nearly 1 in 5 advertisements were for a food or nutrition-related product

Fast-food restaurants, sugary food, chips/crackers, and sugar-added beverages collectively accounted for more than 70% of food commercials

34% were for ''food on the run,'' fast-food restaurants and convenience food The Saturday morning 7-10 AM time slot is more saturated with food commercials Approximately 7.7 food commercials per hour appeared in programming on the

children's networks Approximately 1 food commercial every 8 minutes

Source: http://www.sciencedaily.com/releases/2009/11/091104181155.htm (Report on Journal of Nutrition Education and Behavior)

When children focus on TV while eating, they have a tendency to overeat. They are not paying attention to their body’s hunger cues. Mindless eating (MOOD)

Think Your FOOD before you choose

• Think your FOOD. o Don’t let others tell you what to eat.

• Be Mindful - Don’t just eat o Know why you are eating o Know what you are eating o Know how much you are eating

http://www.sciencedaily.com/releases/2009/11/091104181155.htm



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• Be Mindful - manage the internal want and need debate o Want: What our eyes and mind tell us (want)

vs o Need: What is healthy for our body and brain (need)

• Be Mindful - What o What we want to eat

vs o What we need to eat

• Be Mindful - How much o How much we want to eat

vs o How much we need to eat

• Think Your FOOD influencers - Your emotional state (MOOD) o We have emotional connections with FOOD o We have social connections with FOOD

• Think Your FOOD Influencers - Media and marketers o Advertisements and commercials influence our FOOD and drink choices Emotional appeal Good deal; more FOOD for less money

• Think Your FOOD o Reframe your thinking FOOD is fuel for the body and brain vs FOOD is something to make me feel good or satisfy my taste buds

• FOOD is fuel for our bodies to have energy to move, think, and live.

o We need to eat foods that provide energy for our body and mind to function in our days o Fill your body with healthy fuel Fruits and vegetables Milk and water Not foods high in sugar or fat

o Don’t fill your body with too much FOOD fuel When we eat too much, our body stores the extra fuel as fat



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• Just like cars run on fuel, so do we. o Bad fuel causes a car to break down. o Eating unhealthy foods can be bad for our health. Cardiovascular disease Diabetes High blood pressure Obesity

• Just like cars only need so much fuel, so do we. o Your body needs enough food to meet the needs of your energy expenditure. Don’t overfill your tank If you fill your car tank too full it overflows If you eat too much food, the food calories overflow to fat storage in your body.

Caregivers are instrumental in helping children learn healthy lifestyle habits to combat the pediatric obesity epidemic.

• You can help kids learn to think their FOOD to make healthy FOOD choices.

• Four things you can do to help kids learn make healthy FOOD choices 1. Teach children to Think Your FOOD

2. Educate the parents 3. Be a good role model 4. Implement best practices in your child care setting



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1. Teach Children – Think Your FOOD

• Why child care? Why you? o Children spend many hours in child care More children are in child care today than ever before and Some spend more time in child care than they do at home.

o Child care is a great setting to teach children to think their FOOD choices.

• Caregivers are in a special position to show children what it means to eat for good health, including how important it is to eat a variety of FOODs. o Learning how to make healthy FOOD choices needs to start when children are young. Children are in child care during these crucial learning years

• You have the opportunity every day to teach children about making healthy FOOD choices o What to eat o How to make healthy FOOD choices o To be aware of hunger body cues

o Children should have education on nutrition at least once a week

• It’s important that young children are educated about making FOOD choices. o Children need to understand the difference between healthy and unhealthy FOOD

choices. o Eating habits established in infancy and early childhood may contribute to suboptimal

eating patterns later in life. Source: Preventing Childhood Obesity in Early Care and Education Program guidelines

• Promoting healthy eating is crucial during the young years. Five key reasons:

o Attitude: During child care years, children are developing an attitude towards FOOD The eating behaviors children practice early in life affect their health and nutrition

and are significant factors in childhood overweight and obesity. These behaviors may continue to shape food attitudes and eating patterns

through adulthood. Source: NAEYC Young Children (March 2011) - The Impact of Teachers and Families on Young Children’s Eating Behaviors



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o Habits: If children establish healthy eating habits at a young age, those habits will more than likely follow them through life. Source: NAEYC Young Children (March 2011) - The Impact of Teachers and Families on Young Children’s Eating Behaviors

o Overall Health Benefits: If children eat healthy at a young age, they will have more energy, feel better, and increase their chances to live longer.

o Obesity Prevention: If children start out eating healthy when they are young, their chances of being obese later in life are decreased.

o Ready to Learn: If children start out eating healthy when they are young, they are more ready to learn. Kids learn better when they eat better. Research shows that there are crucial relationships between nutrition and health as

well as nutrition and learning.

• Caregivers can help children get in tune with their hunger cues. Teach them to eat because they are hungry versus eating due to their emotional state at their moment (MOOD). o Preschoolers may say they are hungry when they really mean they are bored, sad, or in

need of attention. To determine if a child is really hungry versus bored, etc. one might suggest that

the child play with a friend or get involved in an activity. Source: https://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/khchildcareguide.pdf

• Key points to teach the children about FOOD

o Be a fit kid Make healthy FOOD choices for your body and brain.

https://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/khchildcareguide.pdf



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o FOOD is fuel for bodies Just like cars need good fuel to function, our bodies need good fuel to function. Healthy FOODs are good fuel for our body

o Why eat healthy FOODs? Healthy FOODs Help your body grow. Give you energy to MOVE and play. Give you energy to think.

o fit kids drink milk and water. Milk and water are good for your body.

o fit kids try new fruits and veggies. Fruits and veggies give you energy to play. Fruits and veggies help bodies grow strong and increase energy

Try It! Start with one bite Encourage (do not force) children to try new fruits and vegetables

o fit kids eat slow It can take your stomach awhile to tell your brain you are full (20 minutes), so eat

slowly.

o fit kids eat when they are hungry and stop when they are full. Stop eating if you are full: Listen to your stomach Just because there is FOOD on your plate it doesn’t mean you need to eat it if

you are full

o fit kids think about their FOOD choices.



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o fit kids are smart when watching television Sometimes you might see FOODs that are high in sugar and fat while watching

television; foods like candy, pop or french fries. These foods are not the healthiest choice for our bodies and minds.

Think before you choose what to eat.

Don’t let TV tell you what to eat. Just because you see it on TV does not mean it is a healthy FOOD for your body.

Don’t let cartoon characters tell you what to eat. Just because your favorite cartoon character is on a FOOD package or box doesn’t mean the FOOD is healthy for your body.

Tools to help teach children about healthy FOOD choices • Have books and games available to help children learn about healthy FOOD choices.

o Read books to children about the importance of: Eating fruits and vegetables Drinking milk and water

o Have books and games available for children to learn about the importance of: Eating fruits and vegetables Drinking milk and water

• The fit Jr. Website has many resources to help children learn about FOOD: o fit Jr. Website

fit.sanfordhealth.org (show in class if possible)



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• My Plate Activity website location: http://www.choosemyplate.gov/ o Purpose: To teach children to fill their plates with fruits and vegetables o Talking Points: Fill your plate with healthy foods Fruits and vegetables are healthy foods for your body and brain Fruits and vegetables Give us energy to play and grow. Help our body strong. Help our brains to think.

Be sure to fill your plate with healthy fruits and vegetables

• Green and Red Plate Game fit website location:need Sanford URL o Purpose: To teach children the difference between healthy (green plate) and unhealthy

FOODs (red plate). o Talking Points: There are lots of FOODs Some FOODs are better for your body and brain than others The best FOODs for you are healthy FOODs (green plate FOODs) You want to eat healthy FOODs Healthy FOODs are good for you:

* Give your body energy to move and play * Help you grow big and strong * Help you to think smart

Fruits and veggies are healthy FOODs * You should eat fruits and veggies every day

Some FOODs have a lot of sugar and too much sugar is not good for your body (red plate FOODS) You need to stop and think to limit the amount of these FOODs you consume.

Sometimes it is hard to know which FOODs are healthy This game will help you learn what FOODs are healthy for you

• TV Screen Game fit website location:need Sanford URL o Purpose:

To teach children the difference between healthy (green plate) and unhealthy FOOD (red plate) and to

Have an awareness of how the messages we see on TV influence our FOOD choices.

o Talking Points: Some FOODs are healthier for us than others When watching TV we see healthy and unhealthy FOODs We can learn to be smart about the FOODs we see on TV Just because you see it on TV does not mean it is a healthy FOOD for your body

http://www.choosemyplate.gov/



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• Healthy Food Hunt fit website location:http://fit.webmd.com/jr/food/pdf/pdf-healthy-food-hunt-game o Purpose: To teach children how to choose healthy snack FOODs. o Talking Points: Sometimes we are hungry for a snack Choose healthy FOODs for your snack Healthy FOODs help your body grow and give you energy to MOVE and play Fruits and vegetables are great snacks

Better Choices Game fit website location: Sanford URL o Purpose: Teach children about healthy FOOD choices with the spotlight tool of red,

yellow, and green. o Talking Points: Fruits and vegetables are a healthy FOOD choice Healthy FOODs help our Muscles grow big and strong. Bones grow strong. Hearts be healthy.

Water and milk are the best drinks to have when you are thirsty. Milk helps us to grow strong bones. Just like plants, our bodies need water to grow.

Green FOODs: In this game, FOODs that are good for our body are green FOODs You want to eat a lot of these every day

* Show an example of a Green FOOD card Yellow FOODs: Some FOODs are okay to eat once in a while In this game, we call these yellow FOODs Slow down and think before you eat these FOODs. Don’t eat too much

* Show an example of a Yellow FOOD card Red FOODs: Some FOODs have a lot of sugar, and too much sugar is not good for your

body In this game, we call these red FOODs. You need to stop and think and only

eat a little bit of these FOODs * Show an example of a Red FOOD card



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• I Want to be a Healthy Kid fit website location:Sanford URL o Purpose: To encourage children to make healthy FOOD choices. o Talking Points: Our bodies need healthy FOODs to grow and have energy to MOVE and play. Fruits and vegetables are healthy FOODs for us. Choose to eat fruits and

vegetables. Choose what healthy FOODs you will eat and drink today.

• Award Ribbons -- Fruit and Vegetable Encouragement fit website locations: http://fit.webmd.com/jr/food/pdf/pdf-ate-new-fruit-award http://fit.webmd.com/jr/food/pdf/pdf-ate-vegetable-award o Purpose: To reinforce being a fit kid and healthy FOOD choices. o Talking Points: A fit kid is someone who does things to help their body be healthy One way to be a fit kid is to make healthy choices about what to eat and drink

• FOOD Activity Guide Purpose – Learning experiences throughout the day o Children learn through experiences. o Short term learning is gained when there is limited exposure to information in one day

or week (i.e. a group time topic). o Retained learning occurs when there is continual exposure to learning in multiple play

areas on a consistent basis within the care environment. o Children need to have continual, consistent exposures to learning experiences that

teach them about making healthy choices so that making healthy choices become a habit.

• FOOD Activity Guide - Let’s Eat Activities o Review the MOOD Activity Guide with class o Emphasize the FOOD Point and fit Connection Highlight the following activities: Vegetable Faces Eat a Fruit Rainbow Healthy Snack Choices

• SD Harvest of the Month website o A great resource for Pre-K fruit and vegetable lesson plans

http://www.sdharvestofthemonth.org/sign-in.html

http://fit.webmd.com/jr/food/pdf/pdf-ate-new-fruit-award

http://www.sdharvestofthemonth.org/sign-in.html



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• Let’s MOVE: Childcare Website o A resource to help caregivers provide a healthy childcare environment

http://healthykidshealthyfuture.org/welcome.html (show in class if possible)

2. Educate the Parents Create an awareness of the pediatric obesity issue and FOOD

• You have the opportunity to speak to parents about FOOD and fit. o Partner with parents to help children learn about making healthy FOOD choices

• Educate Parents - Healthy FOOD choices o Many parents want to learn more about nutrition, and childcare is a great place for

parents to learn from you o Look for opportunities to provide nutrition education to parents

• Educate Parents - Healthy habits are learned early in life o Teach healthy lifestyle habits to your children when they are young o Children learn healthy habits at a young age that will follow them into adulthood

• Educate Parents - FOOD is Fuel for our bodies and minds o What and how much fuel our children eat matters o An overweight 3-year-old child is nearly 8 times as likely to become an overweight

young adult compared to a non-overweight developing 3-year-old. Source: www.zerotothree.org

• Educate Parents - Consistent messages and practices o Partner with parents to create consistency in practices and messages between home

and child care If children hear the same messages from parents and child care providers, they are

more likely to listen and remember.

http://healthykidshealthyfuture.org/welcome.html



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o Consistent message: No “Clean Your Plate” message Children should eat when they are hungry and stop eating when they are full. No “clean your plate” message Emphasis on having a “clean plate” may hinder children’s recognition of the

internal cues of hunger and satiety and contribute to overeating. It is important for adults to respect the child’s expression of food fullness. Source: NAEYC Young Children (March 2011) - The Impact of Teachers and Families on Young Children’s Eating Behaviors

o Consistent message: Trying it takes time Don’t force children to eat a food It may take several times (10-15) before a child will eat a new food.

Sources: Zero to Three; Guidelines for Health Stepping Stones to Caring for our Children: National health and safety performance standards; Guidelines for early care and education programs, 3rd edition. (2013)

Encourage children to try the food; don’t force children to try the food.

o Consistent practice: Correct portion sizes for kids Feed children correct FOOD and drink portion sizes for their age.

o Consistent practice: Limit sugar practice Limit sugar sweetened beverages and high sugar foods to ensure children are not

getting empty calorie, low nutritional foods and drinks in their diet.

o Consistent practice: Limit marketer influence by limiting television Decrease the influence marketers have on your children’s choices. Limit television watching in your home.

• Create Awareness

o Display posters in your child care facility to create awareness of healthy food and beverage choices. Spoonful of Sugar

fit website location:need Sanford URL More for Less is Not Always a Good Deal

fit website location:need Sanford URL

o Inform parents of the learning activities on nutrition provided in the facility Source: Preventing Childhood Obesity in Early Care and Education Program guidelines



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• Provide parents with o Healthy recipes that are quick and inexpensive to prepare. o Information regarding access to local sources of healthy FOODs. o Ideas for healthy and inexpensive snacks, including FOODs available and served at

parent meetings.

• fit parent resources o Provide parents with tools to assist in helping children develop good FOOD habits: I Ate Healthy FOODs Chart

fit website location: http://fit.webmd.com/jr/food/pdf/pdf-healthy-foods-chart Healthy FOOD Hunt

fit website location: http://fit.webmd.com/jr/food/pdf/pdf-healthy-food-hunt-game 2-3 Year Old FOOD Guide

fit website location: http://fit.webmd.com/jr/food/pdf/pdf-how-much-to-feed-chart-2-to-3 4-8 Year Old FOOD Guide

fit website location:http://fit.webmd.com/jr/food/pdf/pdf-how-much-to-feed-chart-4-to-8

3. YOU the Caregiver

• What can caregivers do? How can you help? Change can start with you!

• YOU can promote healthy habits. o Know and promote healthy FOOD habits

o Children may receive between 50% and 75% of their daily calories at the child care

facility. Source: NAPSACC

o Home day care providers are in a special position when it comes to nutrition Family day care providers plan and prepare the meals and are able to choose what

and how much to feed the children in their care. o Center-based providers can help too Sit and eat with the children. Even though center-based child care providers do not prepare the FOOD,

providers can still encourage proper nutrition in the center. * Sit with the children and encouraging the children to eat healthy FOODs

during meals and snack time.



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• YOU can promote the importance of being fit. o The importance of all four pieces working together

• YOU can be a fit role model. o RECHARGE Your Energy o Motivate your MOOD o Think Your FOOD…before you make a FOOD choice

o Eat the same foods and beverages as the children during meal and snack times. Specifically fruits and vegetables

o Drink water throughout the day. o Don’t drink soda or other sweetened beverages in front of children. o Don’t eat fast food or foods high in sugar or fat in front of children. o Talk out loud about personal healthy FOOD favorites. “I really like carrots.”

o Talk out loud about being hungry or full. “I am full so I am not going to eat anymore.”

4. Best Practice Review

• Define Best Practices Review (Optional) o Refer to page 23 of the “Be fit…RECHARGE Your Energy” class outline

• Review of Best Practices: What, Why and How o Why (why is this best practice important) Methods that have been proven to work

o What (what is the best practice) What you do to get the best results

o How (how can providers achieve this best practice) Follow the fitCare Student Manual Guidelines



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FOOD Best Practices

• FOOD Best Practices are reviewed in the fitCare Student Manual.

(Instructor can show class participants the location of the FOOD section in the fitCare Student Manual) o FOOD Best Practices: What, Why, and How Why is this best practice important? What is the best practice? How can providers achieve this best practice?

Policy first

• Have a written policy relative to children’s nutrition.

o Definition of a policy: A written policy is a statement about the importance you give to something in your

child care program.

A written expectation to continually guide the practice of child care leadership and staff in the child care setting.

Helps provide a means to meet the goals of providing children an environment in

which to learn about and practice healthy eating habits.

o Why a written policy is important: Parent Communication: Policy statements can help child care providers and

families understand why healthy food and drink choices are so important relative to children’s health, development, and weight.

You can use a policy statement in your program handbook, descriptions, advertisements, and materials you give parents to inform them of how important healthy food and drink choices are for children’s health, development, and weight.

Staff communication: When new staff starts working at the child care facility, written

policies will help them learn about responsibilities and expectations of the program. Provides guidelines of what to do/what is expected in practice. Ensures consistency in practice.



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o Include in your FOOD policy such things as: What foods are provided to the children

What beverages are provided to the children

Support of breastfeeding mothers and their infants Welcome breastfeeding mothers Make sure staff members are trained to handle breast milk and follow mothers’

feeding plans. * Mothers breastfeeding at 6 months was significantly associated with

support from child care providers to feed expressed breast milk to infants and allow mothers to breastfeed on-site before or after work.

Source: http://www.cdc.gov/breastfeeding/pdf/strategy6-support-breastfeeding-early-care.pdf

Provision of healthy mealtime environments

Teacher expectation to encourage healthy eating with children Do not offer food to calm down a child Do not offer food as a reward for appropriate behavior

Guidelines on food for holidays and celebrations

Fundraising with non-food items

Staff education on child nutrition to be provided

Parent education on child nutrition to be provided

Planned and informal nutrition education for children to be provided Source: http://gonapsacc.org/resources/nap-sacc materials/Go_NAP_SACC_Child_Nutrition_SelfAssessment.pdf

• Policies don’t have to be complex and hard to write: o Sample FOOD Policy In our program, we provide children with a variety of healthy foods at each meal

(fruits, vegetables, whole grains, and protein). With the exception of infants still being bottle-fed or eating baby food, all children

are offered the same food during meal time (unless an allergy or medical condition is present).

Infants are fed on demand when an infant provides cues of needing to be fed. Children are not forced to “clean” their plates (eat every food item served). FOOD is not used as a reward for good behavior or taken away as a punishment. Children are provided education on the importance of healthy eating once a week.



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FOOD Best Practices Highlights

• Help children Think their FOOD choices

• Meals and snacks

o Meet the requirements for meals of the child care component of the USDA (U.S. Department of Agriculture) or the CACFP (Child and Adult Care FOOD Program)

o A weekly menu (meals and snacks), Includes a combination of new and unfamiliar FOODs. Includes a variety of colors, flavors, textures, and shapes. Offers dark green, orange, red, or deep yellow vegetables to children. Is available to parents.

o Meal and snack time is child centered and age-appropriate.

o Select and arrange FOOD on plates in ways that make meals interesting and attractive.

o Have appropriate servings available to children throughout their day. Ensure that the children’s daily nutrition needs are met. Small meals of nourishing

food should be scheduled over the course of the day. Young children, under the age of six, need to be offered food every two to three

hours. Source: http://cfoc.nrckids.org/StandardView/4.2.0.5

• Support breastfeeding mothers and their infants. o Know how to prepare, store, and feed human milk

o There is a need to support breastfed infants Breast-feeding seems to have a small but consistent protective effect against

obesity in children. Source http://www.ncbi.nlm.nih.gov/pubmed/15314625

Nationwide, 77% of mothers breastfeed Healthy people 2020 objective: Increase the proportion of infants who are breastfed

* Ever – 81.9% * 6 months – 60.6% * 1 year – 34.1%

Source :http://www.cdc.gov/breastfeeding/pdf/2013breastfeedingreportcard.pdf Early childhood programs that support breastfeeding families help women start and

continue breastfeeding.

http://www.ncbi.nlm.nih.gov/pubmed/15314625



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• Think Your FOOD - Top 3 Best Practices o Correct portion sizes o More fruits and vegetables in our daily FOOD intake o Drink less or limit sweetened beverages

• Portion control o Read FOOD labels to know the correct serving o Serve child size servings Foods Drinks

• Encourage children to consume more fruits and vegetables daily. o Even if you don’t prepare the FOOD, You can teach children about fruits and vegetables. You can encourage children to try fruits and vegetables at mealtime and snack

time. You can role model eating fruits and vegetables at mealtime.

Note: French fries, tater tots, and hash browns don't count as vegetables

o The fruits and vegetables challenge It is common for children to not get an adequate intake of fruits and vegetables in

their daily diet Who wants to argue over eating fruits and vegetables?

Encourage children to try vegetables Children have a tendency to not eat vegetables, and they often claim they don’t

like them. Remember, children need to see a new FOOD 10-15 times before they will

actually try it. Do not give up. Sources: Zero to Three; Guidelines for Health Stepping Stones to Caring for our Children: National health and safety performance standards; Guidelines for early care and education programs, 3rd edition. (2013)

Ways to get kids to LOVE their fruits and vegetables (or at least try them!) Serve them creatively Have a party of the senses



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Incorporate fruits and vegetables into lessons by trying fruits and vegetables from different places around the world. Veggie Face Activity (FOOD Activity Guide) Eat a Rainbow Activity (FOOD Activity Guide)

Ask participants what has worked for them

• Limit sugar in children’s food and drinks.

o Read the label – check for sugar in fruit drinks and juice. o Soda and fruit drinks are full of sugar and “empty calories” (few nutrients, many

calories). Studies show that children who drink more soft drinks are more likely to be

overweight.

o Serve 100% fruit or vegetable juice without added sweetener: Even 100% juice is high in sugar and provides fewer nutritional benefits than fresh

fruit. It is recommended that children limit their consumption of 100% juice.

* 4-6 ounces of 100% juice twice a week Source: https://gonapsacc.org/resources/nap-sacc-materials/GoNAPSACC_CN_2014.pdf

o Promote and encourage drinking milk: Children two years of age and older should be served skim or 1% pasteurized milk.

Source: Preventing Childhood Obesity in Early Care and Education Program guidelines (Standard 4.3.1.7)

Recommended Serving sizes: 2-3 Year olds: ½ cup 4-5 Year olds: ½ - ¾ cup

o Promote drinking water throughout the day: Water is a simple, inexpensive, healthy beverage choice for children. Replacing sweetened drinks, even 100% juice, with water is an inexpensive and

easy way to help improve children’s health, as well as your budget. Source: http://nrckids.org/index.cfm/products/licensing-toolkits/child-care-providere28099s-action-sheet-use-of-water-and-100-juice/

http://nrckids.org/index.cfm/products/licensing-toolkits/child-care-providere28099s-action-sheet-use-of-water-and-100-juice/

http://nrckids.org/index.cfm/products/licensing-toolkits/child-care-providere28099s-action-sheet-use-of-water-and-100-juice/



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Drinking water should be readily available and easily accessible, both inside and outside, for children Source: Preventing Childhood Obesity in Early Care and Education Program guidelines Water fountains Sippy cups Insulated plastic glasses with attached straws

o Set up the meal and snack time to encourage healthy eating: Engage with the children during meal and snack time. Sit at the table and eat the meal or snack together. Serve meals family style Serving family style enhances motor skills, language development, table

manners, social skills, self-esteem, and independence. Encourage self-feeding by older infants/toddlers. Promote consumption of fruits and vegetables in your conversations.

o Plan plenty of time for children to eat without feeling rushed. Children are capable of regulating their FOOD intake. It is important to respect the child’s expression of fullness and to follow a schedule

that gives children enough time to eat. Source: NAEYC Young Children (March 2011) - The Impact of Teachers and Families on Young Children’s Eating Behaviors (add to references)

o Allow children “not” to finish eating meals Create a positive eating environment by listening when a child says he/she is full. Discourage the “clean your plate” habit.

Forcing children to eat more than they can handle causes children to eat more than they need and can cause them to Gain weight. Develop a habit of eating even when they are full.

Toddlers may not say they are full, but may start playing or become distracted, shaking their head “no” and not finish.

• Do not use FOOD to manage children’s behaviors.

o Do not use FOOD as a reward or bribe. Do not reward children with FOOD for appropriate behavior.



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o Do not withhold FOOD as a punishment. Do not threaten to take FOOD away from children for inappropriate behavior.

• Limit screen time: Minimize Marketer influence

• Provide an environment that encourages children to make healthy choices. o Help children talk through feelings versus eating as a way to deal with feelings (MOOD

connection).

o Provide rest so Children can manage emotions better to make good choices when they are well-

rested (RECHARGE connection). Being tired can cause the brain to send miscued messages of being hungry when

you are really just tired.

o Provide physical activity in a child’s day to expend caloric intake (MOVE connection).

• Ensure staff are educated on o The importance of providing children with healthy FOODs. o The importance of appropriate serving sizes for children. o The importance of fruit and vegetable consumption. o Sweetened beverage consumption and the need to drink water and milk. o The importance of eating with the children and role modeling healthy food and drink

choices and habits. o Staff should have training on children and nutrition at least two times a year.



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• Educate children at least once a week o Lesson plans should include teaching the children about the importance of eating fruits

and vegetables. o Lesson plans should include teaching the children about the importance of drinking

water and milk.

• Educate children o Make healthy FOOD choices to provide healthy fuel for your body and brain.

o Understand why it is important to eat fruits and vegetables every day. o Drink water and milk.

o Understand how marketers influence our choices.

• Educate Parents o Serve healthy foods at home. Talk about the importance of providing healthy FOODs at home. Educate parents on the importance of serving age appropriate serving sizes to

their children. Educate parents on the importance of fruit and vegetable consumption. Educate parents on sweetened beverage consumption and the need to drink water

and milk.

• Be a positive role model for children in your care. o Start today. Do one thing to be a good role model. Challenge yourself to start being a good role model for children in your care on how

to Think your FOOD. Eat with children and demonstrate healthy eating.



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Do not drink pop or coffee in front of children. Encourage drinking of water and milk.

Self-Assessment Tools

• Practice FOOD fitCare Best Practices o How can you get started? o What can you do?

• Find out how you are doing o Take a FOOD Self-Assessment Check out if you are practicing fitCare FOOD Best Practices Learn what you are doing well Learn what you can improve on Try one new thing to improve your fitCare FOOD Best Practices

• Review FOOD Self-Assessment with participants: o Scoring Review o Planning for Action o Pre-Assessment o Post-Assessment

• Completion options:

o You may complete the Self-Assessment at the end of class or o Take home to complete after class.



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• Review Move Challenge - www.healthykidshealthyfuture.org o Complete an online interactive checklist to assess what quality improvements can be

made related to five goals and create a customized action plan. 1. Physical activity 2. Screen Time 3. Food 4. Beverages 5. Infant Feeding

o Upon successful completion of the action plans, caregivers can retake the online assessment and receive a certificate of recognition for their efforts.

Conclusion

• What to remember from today:

• fit recognizes that our MOOD and RECHARGE influence our FOOD and MOVE choices.

o Influencers Emotions and Attitudes – MOOD Rest and Energy levels – RECHARGE

o Choices Nutritional choices – FOOD Physical activity choices – MOVE

http://www.mmsend43.com/link.cfm?r=666804183&sid=16246864&m=1604568&u=NACCRRA&j=7820647&s=http://healthykidshealthyfuture.org/content/hkhf/home/startearly/howtosignup.html



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• Being fit is about o Having the right mindset and enough energy

to be able to choose o Healthy foods and to be active

• Be fit -- Think Your FOOD o FOOD is fuel for our body and mind: Energy to MOVE Energy to think Energy to live life

• Healthy eating habits start young. o Children need to be taught healthy FOOD habits.

• Practice fitCare Best Practices. o FOOD Best Practices

• Have a nutrition policy to guide fitCare FOOD Best Practices.

• Insure children are receiving the right portions of FOOD for their age. o Allow children to regulate intake o Do not use the “clean you plate” practice

• Encourage fruit and vegetable consumption by serving daily.



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• Limit sweetened beverages. o Serve milk and water

• Support breastfeeding mothers and their infants.

• Provide a healthy fit environment – Limit media influence. o Media influences children’s healthy FOOD choices Limit screen time

• Teach children about making healthy FOOD and drink choices.

• Teach children to be a fit kid. o Think Your FOOD o Make healthy FOOD choices

o Eat fruits and vegetables Encourage eating fruits and vegetables during meal and snack time conversations.

o Drink water and milk

o Eat when you are hungry; stop eating when you are full. Encourage children to read body cues of being hungry and full.



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o Encourage children to not eat foods just because they see them on TV or a computer screen. Just because you see it on TV does not mean it is a healthy FOOD for your body Just because your favorite cartoon character is on a FOOD package or box it

doesn’t mean the FOOD is healthy for your body

• Partner with parents o Educate parents about healthy FOOD choices for children o Children learn best when there are consistent messages and practices between home

and child care.

• Be a role model o RECHARGE Your Energy o Motivate your MOOD o Think Your FOOD…before you make a FOOD choice o Eat healthy foods and drink beverages with the children to role model healthy eating

choices. o Talk about making healthy food choices and healthy eating habits to reinforce children’s

awareness. “I really like carrots.” “I am full so I am not going to eat anymore.”

• Practice fitCare Best Practices o Have policies to guide fitCare Best Practice Serve child sized portions Encourage consumption of fruits and vegetables Limit sugar and sweetened beverages

One Thing…I Will Do

1. Closing Activity: One Thing…I Will Do

o Purpose: 1. To have participants acknowledge an action to put into practice based on what they

have learned in class o Materials:

1. One Thing I Will Do Card (Participant keeps this card) o Participant completes One Thing I Will Do Card



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Post-Class Questionnaire (Optional)

Used to track class knowledge gain and participants’ intent to put knowledge into practice • Post-Class Questionnaire

o Participant completes Post-Class Questionnaire Answers Questions 1-10 Copies action noted on One Thing…I Will Do card onto Post-Class Questionnaire

in “One Thing I Will Do” section Completes confidence score Answers class evaluation questions

o Participant turns Post-Class Questionnaire into instructor o Instructor reviews correct answers with participants o Submit fitCare Post-Class Questionnaire to data collection office or designated

personnel.



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Resources 1. American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child

Care and Early Education. 2011. Caring for our children: National health and safety performance standards; Guidelines for early care and education programs. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. Also available at http://nrckids.org.

2. “Breastfeeding Report Card: United States”. Center for Disease Control and Prevention, 2013 n.d Web. Spring 2014. 3. "Breast-feeding and Childhood Obesity--a Systematic Review." National Center for Biotechnology Information. U.S.

National Library of Medicine, n.d. Web. Spring 2014. 4. "Bright Futures: Health Care Professionals Tools and Resources." Bright Futures. American Academy of Pediatrics, 2008.

n.d. Web. Spring 2014. 5. “Crediting Handbook for the Child and Adult Care Food Program.” Agriculture, United States Department Of. n.d. Web. Spring

2014. 6. "Child Nutrition Self-Assessment." NapSACC. Blue Cross and Blue Shield of North Carolina, 2014. Web. Spring 2014. 7. Childhood Obesity Prevention." Early Childhood Obesity Prevention”. Center for Disease Control and Prevention,

Nemours, n.d. Web. Spring 2014. 8. Childhood Overweight and Obesity. Centers for Disease Control and Prevention, 05 Aug. 2013. Web. Spring 2014. 9. "ChooseMyPlate.gov." ChooseMyPlate.gov. United States Department of Agriculture, n.d. Web. Spring 2014. 10. "Early Experiences Matter." ZERO TO THREE: Homepage. National Center for Infants, Toddlers, and Families, n.d. Web.

Spring 2014. 11. Eliassen, Erin K. "The Impact of Teachers and Families on Young Children's Eating Behaviors." Naeyc.org. NAEYC, Mar.

2011. Web. Spring 2014. 12. "FitSource." U.S. Department of Agriculture. United States Department of Agriculture, 5 May 2014. Web. Spring 2014. 13. G., Md Mary L. Gavin, Md Steven A. Dowshen, and Neil Izenberg. "Child Care Providers Guide: Helping Kids Eat Right

and Stay." (n.d.): n. pag. The Nemours Foundation/KidsHealth®, 2011. Web. Spring 2014 14. Hannah E. Bush, Lynn Rossy, Laurie B. Mintz, and Laura Schopp (2014) Eat for Life: A Work Site Feasibility Study of a Novel

Mindfulness-Based Intuitive Eating Intervention. American Journal of Health Promotion: July/August 2014, Vol. 28, No. 6, pp. 380-388.

15. "Healthy from the Start; How Feeding Nurtures Your Young Child’s Body, Heart and Mind." (n.d.): n. pag. Zero to Three, 2006. Web. Spring 2014.

16. "Healthy Meal Resource System." National Agricultural Library. USDA, n.d. Web. Spring 2014. 17. "Healthy South Dakota." Healthy South Dakota. Department of Health, n.d. Web. Spring 2014. 18. "How to Teach Nutrition to Kids." Nutrition for Kids. Carrot Press, n.d. Web. 12 May 2014. 19. "Indicator Selection | KIDS COUNT Data Center." South Dakota Indicator. Annie E Casey Foundation, 2014. Web. Spring

2014. 20. "It's Easy to Go Nap SACC." NapSACC. Blue Cross and Blue Shield of North Carolina, 2014. Web. Spring 2014. 21. "KidsHealth from Nemours." KidsHealth. Nemours, n.d. Web. Spring 2014. 22. "Let's Move." Let's Move! Whitehouse.gov, n.d. Web. Spring 2014. 23. National Resource Center for Health and Safety in Child Care and Early Education. N.p., n.d. Web. Spring 2014. 24. "News in Brief, August–October 2011." Contemporary Arab Affairs 5.1 (2012): 166-76. Web. 25. Nguyen-Rodriguez, Selena T., Jennifer B. Unger, and Donna Spruijt-Metz. "Psychological Determinants of Emotional Eating in

Adolescence." NIH Public Access. N.p., May 2009. Web. Spring 2014. 26. "Our Nations Leading Voice For Child Care." Our Nations Leading Voice For Child Care. NACCRRA, 8 May 2014. Web.

Spring 2014. 27. "Preventing Childhood Obesity in Early Care and Education Programs." Preventing Childhood Obesity in Early Care and

Education Programs. National Resource Center for Health and Safety in Child Care and Early Education, Mar. 2012. Web. Spring 2014

28. Stepping Stones to Caring for our Children: National health and safety performance standards; Guidelines for early care and education programs, 3rd edition. (2013). American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education.

29. "Support for Breastfeeding in Early Care and Education." Center for Disease Control and Prevention, n.d. Web. Spring 2014. 30. "The New (Ab) Normal." Division of Community Health: Making Healthy Living Easier. Centers for Disease Control and Prevention,

18 May 2012. Web. Spring 2014. 31. "TV Bombards Children With Commercials For High-fat And High-sugar Foods." ScienceDaily. Elsevier Health Sciences,

5 Nov. 2009. Web. Spring 2014.



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32. Ward D, Morris E, McWilliams C, Vaughn A, Erinosho T, Mazzuca S, Hanson P, Ammerman A, Neelon S, Sommers J, Ball S. (2014). Go NAP SACC: Nutrition and Physical Activity Self-Assessment for Child Care, 2nd Edition. Center for Health Promotion and Disease Prevention and Department of Nutrition, University of North Carolina at Chapel Hill.

33. WebMD - Better Information. Better Health." WebMD. Fit Kids, n.d. Web. Spring 2014. 34. “WebMD Fit Juniors." Fit.WebMD. Sanford & WebMD, n.d. Web. Spring 2014 35. Yale Rudd Center for Food Policy & Obesity. "Fast Food Restaurants Dish Up Unhealthy Marketing to Youth." RWJF. N.p., 08

Nov. 2010. Web. Spring 2014 36. Young, Lisa R. "The Contribution of Expanding Portion Sizes to the US Obesity Epidemic." US National Library of

Medicine. AM J Public Health, Feb. 2002. Web. Spring 2014.



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1. What are the healthiest drinks for children to

consume? a. Water and 100% Fruit Juice b. Milk and 100% Fruit Juice c. Water and Milk d. Sports Drinks and Water

2. Juice for preschool children should be limited to while

in child care: a. Children should not drink juice during child care b. 4-6 ounces once a day c. 4-6 ounces twice a week

3. A typical 12-ounce soda contains about ____

teaspoons of sugar. a. 4 teaspoons b. 8 teaspoons c. 10 teaspoons

4. One 12-ounce can of soda has as much sugar as:

a. 3 servings of Frosted Flakes breakfast cereal b. 1 slice of pecan pie c. 1 cup of chocolate ice cream d. All of the above

5. Soft drinks and fruit drinks (fruitades and fruit punch)

are a major source of added sugar in the American Diet. a. TRUE b. FALSE

6. Americans get about __ teaspoons of sugar a day.

a. 8.9 teaspoons b. 15.7 teaspoons c. 22.2 teaspoons

7. People who consume sugary drinks regularly (one to two cans a day or more) have a __ greater risk of developing type 2 diabetes than people who rarely have such drinks. a. 10% b. 15% c. 26% d. 33%

8. Before the 1950s, standard soft-drink bottles were:

a. 6 ounces b. 6.5 ounces c. 8 ounces d. 10 ounces

9. For each additional 12-ounce soda children consumed each day, the odds of becoming obese is increased by: a. 25% b. 45% c. 50% d. 60%

10. Just one fruit drink, regular soda, or energy drink

contains more added sugar than most young people should consume in an entire day. a. TRUE b. FALSE

Sugary Drink Quiz



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1. What are the healthiest drinks for children to

consume? a. Water and 100% Fruit Juice b. Milk and 100% Fruit Juice c. Water and Milk (2) d. Sports Drinks and Water

2. Juice for preschool children should be limited to while

in child care: a. Children should not drink juice during child care b. 4-6 ounces once a day c. 4-6 ounces twice a week (6)

3. A typical 12-ounce soda contains about ____

teaspoons of sugar. a. 4 teaspoons b. 8 teaspoons (3) c. 10 teaspoons

4. One 12-ounce can of soda has as much sugar as:

a. 3 servings of Frosted Flakes breakfast cereal b. 1 slice of pecan pie c. 1 cup of chocolate ice cream d. All of the above (3)

5. Soft drinks and fruit drinks (fruitades and fruit punch)

are a major source of added sugar in the American Diet. a. TRUE (4) b. FALSE

6. Americans get about __ teaspoons of sugar a day.

a. 8.9 teaspoons b. 15.7 teaspoons c. 22.2 teaspoons (4)

7. People who consume sugary drinks regularly (one to two cans a day or more) have a __ greater risk of developing type 2 diabetes than people who rarely have such drinks. a. 10% b. 15% c. 26% (5) d. 33%

8. Before the 1950s, standard soft-drink bottles were:

a. 6 ounces b. 6.5 ounces (5) c. 8 ounces d. 10 ounces

9. For each additional 12-ounce soda children consumed each day, the odds of becoming obese is increased by: a. 25% b. 45% c. 50% d. 60% (5)

10. Just one fruit drink, regular soda, or energy drink

contains more added sugar than most young people should consume in an entire day. a. TRUE (1) b. FALSE

Sugary Drink Quiz



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Sugary Drink Quiz Sources 1. Harris, Jennifer L., Ph.D, M.B.Aa, Marlene B. Schwartz, Ph.D., and Kelly D. Brownell, Ph.D. "Evaluating Sugary Drink

Nutrition and Marketing to Youth." (n.d.): n. pag. Yale Rudd Center, Oct. 2011. Web. 2014. http://www.sugarydrinkfacts.org/resources/SugaryDrinkFACTS_Report_Conclusions.pdf

2. “Healthy Drinks for Kids." KidsHealth - the Web's Most Visited Site about Children's Health. Ed. Mary L. Gavin. The Nemours Foundation, 01 June 2011. Web. 2014. http://kidshealth.org/parent/nutrition_center/healthy_eating/drink_healthy.html

3. Lehman, Shereen, MS. "Guess How Much Sugar Is in a Can of Soda." About.com Nutrition. N.p., 11 Feb. 2014. Web.

2014. http://nutrition.about.com/od/healthyappetizerssnacks/f/how-much-sugar-in-cola.htm

4. Sugar 101. American Heart Association, 24 Feb. 2014. Web. 2014.

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar 101_UCM_306024_Article.jsp

5. “Sugary Drinks and Obesity Fact Sheet." The Nutrition Source. Harvard School of Public Health, n.d. Web. 2014.

http://www.hsph.harvard.edu/nutritionsource/sugary-drinks-fact-sheet/ 6. Ward D, Morris E, McWilliams C, Vaughn A, Erinosho T, Mazzuca S, Hanson P, Ammerman A, Neelon S, Sommers J,

Ball S. (2014). Go NAP SACC: Nutrition and Physical Activity Self-Assessment for Child Care, 2nd Edition. Center for Health Promotion and Disease Prevention and Department of Nutrition, University of North Carolina at Chapel Hill.

http://www.sugarydrinkfacts.org/resources/SugaryDrinkFACTS_Report_Conclusions.pdf

http://kidshealth.org/parent/nutrition_center/healthy_eating/drink_healthy.html

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar101_UCM_306024_Article.jsp

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar101_UCM_306024_Article.jsp

http://www.hsph.harvard.edu/nutritionsource/sugary-drinks-fact-sheet/



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1. A box of popcorn had 270 calories 20 years ago.

How many calories do you think today’s popcorn has? a. 520 b. 630 c. 820

2. How many green grapes are in a serving?

a. 5 b. 15 c. 30

3. What does a serving of pancakes look like?

a. One 4″ pancake b. One 6″ pancake c. Two 5″ pancakes

4. How many strawberries are in a serving?

a. 5 b. 10 c. 8

5. How many baby carrots are in a serving?

a. 6 b. 10 c. 15

6. How many French fries are in a serving? a. 10 b. 20 c. 30

7. Where do you find the “serving size’ on a food item?

a. The bottom of the box or container b. On the lid of the box or container c. Top of the nutrition label

8. A serving of ice cream most closely resembles: a. An egg b. A tennis ball c. A light bulb

9. A serving of most salad dressings is:

a. 2 teaspoons b. 1 tablespoon c. 2 tablespoons

10. A blueberry muffin 20 years ago was 1.5 ounces

and had 210 calories. How many calories do you a blueberry muffin is today? a. 320 b. 415 c. 500

(Adult Servings)



49

1. A box of popcorn had 270 calories 20 years ago.

How many calories do you think today’s popcorn has?

a. 520 b. 630 (1) c. 820

2. How many green grapes are in a serving?

a. 5 b. 15 (1) c. 30

3. What does a serving of pancakes look like?

a. One 4″ pancake (1) b. One 6″ pancake c. Two 5″ pancakes

4. How many strawberries are in a serving?

a. 5 (1) b. 10 c. 8

5. How many baby carrots are in a serving?

a. 6 (1) b. 10 c. 15

6. How many French fries are in a serving? a. 10 (1) b. 20 c. 30

7. Where do you find the “serving size’ on a food item?

a. The bottom of the box or container b. On the lid of the box or container c. Top of the nutrition label (1)

8. A serving of ice cream most closely resembles:

a. An egg b. A tennis ball (1) c. A light bulb

9. A serving of most salad dressings is:

a. 2 teaspoons b. 1 tablespoon c. 2 tablespoons (1)

10. A blueberry muffin 20 years ago was 1.5 ounces

and had 210 calories. How many calories do you a blueberry muffin is today? a. 320 b. 415 c. 500 (2)

(Adult Servings) Answers in BOLD – Source noted



50

Portion Control Quiz Sources

1. Choose a Food Group.” ChooseMyPlate.gov. USDA, n.d. Web. Spring 2014 http://www.choosemyplate.gov/food-groups/

2. “Eat Right. Get Active. Reduce Screen Time.” Welcome to We Can!, NHLBI, NIH. U.S. Department of Health and

Human Services, n.d. Web. Spring 2014. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/distortion.htm

http://www.choosemyplate.gov/food-groups/

http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/distortion.htm



51

1. Children ages 2-5 spend ___ hours per week watching TV videos, and using a game console. a. Less than 10 hours per week b. 20 hours per week c. 32 hours per week

2. Fast-food restaurants, sugary food, chips/crackers, and sugar-added beverages account for ___% of food commercials? a. 25% b. 55% c. 70%

3. What percentage of commercials are for ''food on

the run,'' fast-food restaurants and convenience food? a. 34% b. 53% c. 72%

4. Food advertisers spend large amounts of money

marketing to toddlers. a. TRUE b. FALSE

5. The main reasons food advertisers market to

young children is to: a. Build brand awareness b. Create a desire to want a particular food product c. Create children to influence parents to buy a food

products d. All of the above

6. How often do parents honor children’s food

requests when shopping in the store? a. 33% of the time b. 50% of the time c. 72% of the time

7. A child's first request for a product typically occurs at what age? a. 24 months old b. 30 months old c. 36 months old

8. The most requested first in-store request is:

a. Candy b. Pop c. Cereal

9. Heavy TV viewers follow a diet more similar to

the TV-advertised diet than do lighter viewers? a. TRUE b. FALSE

10. What category of food advertisements to children has increased the most from 2007 to 2013? a. Cereal b. Fast Food c. Bottled Water d. Sports drinks

11. Children’s exposure to ads for candy products

has _______ from 2007 to 2013. a. Decreased b. Stayed the same c. Doubled d. Tripled

12. Reduced media use is insufficient by itself as

food advertising has increased in other types of media children use, such as the Internet. a. TRUE b. FALSE



52

1. Children ages 2-5 spend ___ hours per week watching TV videos, and using a game console. a. Less than 10 hours per week b. 20 hours per week c. 32 hours per week (4)

2. Fast-food restaurants, sugary food, chips/crackers, and sugar-added beverages account for ___% of food commercials? a. 25% b. 55% c. 70% (1)

3. What percentage of commercials are for ''food on

the run,'' fast-food restaurants and convenience food? a. 34 (1) b. 53% c. 72%

4. Food advertisers spend large amounts of money

marketing to toddlers. a. TRUE (3) b. FALSE

5. The main reasons food advertisers market to

young children is to: a. Build brand awareness b. Create a desire to want a particular food product c. Create children to influence parents to buy a food

products d. All of the above (3)

6. How often do parents honor children’s food

requests when shopping in the store? a. 33% of the time b. 50% of the time (3) c. 72% of the time

7. A child's first request for a product typically occurs at what age? a. 24 months old (3) b. 30 months old c. 36 months old

8. The most requested first in-store request is: a. Candy b. Pop c. Cereal (3)

9. Heavy TV viewers follow a diet more similar to

the TV-advertised diet than do lighter viewers? a. TRUE (2) b. FALSE

10. What category of food advertisements to children has increased the most from 2007 to 2013? a. Cereal b. Fast Food (5) c. Bottled Water d. Sports drinks

11. Children’s exposure to ads for candy products

has _______ from 2007 to 2013. a. Decreased b. Stayed the same c. Doubled (5) d. Tripled

12. Reduced media use is insufficient by itself as

food advertising has increased in other types of media children use, such as the Internet. a. TRUE (1) b. FALSE

Answers in BOLD – Source noted



53

Food Media Mania Quiz Sources

1. Elsevier Health Sciences. "TV Bombards Children With Commercials For High-fat And High-sugar Foods." ScienceDaily. ScienceDaily, 5 November 2009. www.sciencedaily.com/releases/2009/11/091104181155.htm

2. "News Bureau | University of Illinois." TV Ads Market Junk Food to Kids, New Study Finds. N.p., 24 Aug. 2005.

Web. 18 July 2014 http://www.news.illinois.edu/news/05/0824junkfood.html

3. Story, Mary, and Simone French. "Food Advertising and Marketing Directed at Children and Adolescents in the

US." National Center for Biotechnology Information. U.S. National Library of Medicine, 10 Feb. 2004. Web. 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC416565/

4. Television (TV) and Children: Your Child:. University of Michigan Health System, Aug. 2010. Web. 2014.

http://www.med.umich.edu/yourchild/topics/tv.htm

5. Yale Rudd Center, Www.yaleruddcenter.org. "Trends in Television Food Advertising to Young People: 2013 Update." (n.d.): n. pag. May 2014. Web. http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddReport_TVFoodAdvertising_6.14.pdf

http://www.sciencedaily.com/releases/2009/11/091104181155.htm

http://www.news.illinois.edu/news/05/0824junkfood.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC416565/

http://www.med.umich.edu/yourchild/topics/tv.htm

http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddReport_TVFoodAdvertising_6.14.pdf

One Thing I Will Do One Thing… I will do to provide fitCare for children in my care:

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

One Thing I Will Do One Thing… I will do to provide fitCare for children in my care:

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

Think Your FOOD (Pre-Class Questionnaire) Date __________________ Please read the following statements and circle your answers

1. Children are capable of self-regulating their food intake. TRUE FALSE

2. Marketers attempt to influence children’s food choices by what age?

Toddler years

Preschooler years

K-2 Grade years

3-5 Grade years

3. What is the best drink choice for children? Water and Milk

Milk and Juice

Juice and Water

Milk and Soda

4. At what age do eating habits start to develop? Infancy Toddler Years

Preschool Year

Early School-age

5. How long does it take for your brain to give you the message you are full? 5 Minutes 10 Minutes 20 Minutes 30 minutes

6. It is important to enforce a “clean you plate” philosophy when children are eating. TRUE FALSE

7. How many times can it take for children to be exposed to a food before they will try it? 1-2 3-5 5-10 10-15+

8. It is important to sit with children during mealtime and eat the same foods as the children. TRUE FALSE

9. It is okay to drink pop/soda in front of children. TRUE FALSE

10. Offering children sweets to encourage good behavior is an appropriate discipline method. TRUE FALSE

Office Use only: Quiz Score ________

Think Your FOOD (Post-Class Questionnaire) Date _________________ Please read the following statements and circle your answers

1. Children are capable of self-regulating their food intake. TRUE FALSE


Toddler years

Preschooler years

K-2 Grade years

3-5 Grade years


Milk and Juice

Juice and Water

Milk and Soda


Preschool Year

Early School-age


6. It is important to enforce a “clean you plate” philosophy when children are eating. TRUE FALSE

7. How many times can it take for children to be exposed to a food before they will try it? 1-2 3-5 5-10 10-15+


9. It is okay to drink pop/soda in front of children. TRUE FALSE

10. Offering children sweets to encourage good behavior is an appropriate discipline method. TRUE FALSE

What is one thing you want to do after attending this class?

When do you plan to start doing this action?

The next time I am with the children

Sometime next week

Sometime within

the month

Not sure

On a scale of 1-10 how confident are you that you will be able to do this? Not at all Very

1 2 3 4 5 6 7 8 9 10

Strongly Disagree Disagree Agree Strongly

Agree

1. Instructor(s) presented information in a manner that made it easy for me to apply in my work with children. 1 2 3 4

2. I have a better understanding of what I can do to help combat pediatric obesity with the children in my care. 1 2 3 4

3. The materials I received in class will be helpful when educating the children. 1 2 3 4

4. The materials I received in class will be helpful when working with parents. 1 2 3 4

5. This class met my expectations. 1 2 3 4


Think Your FOOD (Answer Key) Date _________________ Please read the following statements and circle your answers

1. Children are capable of self-regulating their food intake. TRUE FALSE Children are born with the ability to know when they're full


Toddler years

Preschooler years

K-2 Grade years

3-5 Grade years


Milk and Juice

Juice and Water

Milk and Soda


Preschool Years

Early School-age


6. It is important to enforce a “clean your plate” philosophy when children are eating. TRUE FALSE

When told to clean the plate, a child is encouraged to override

any feelings of fullness 7. How many times can it take for children to be exposed to a

food before they will try it? 1-2 3-5 5-10 10-15+


9. It is okay to drink pop/soda in front of children. TRUE FALSE Children learn by watching what you do

10. Offering children sweets to encourage good behavior is an appropriate discipline method. TRUE FALSE This practice encourages

emotional eating habits

What is one thing you want to do after attending this class?

When do you plan to start doing this action?

The next time I am with the children

Sometime next week

Sometime within

the month

Not sure

On a scale of 1-10 how confident are you that you will be able to do this? Not at all Very

1 2 3 4 5 6 7 8 9 10

Strongly Disagree Disagree Agree Strongly

Agree

1. Instructor(s) presented information in a manner that made it easy for me to apply in my work with children. 1 2 3 4

2. I have a better understanding of what I can do to help combat pediatric obesity with the children in my care. 1 2 3 4

3. The materials I received in class will be helpful when educating the children. 1 2 3 4

4. The materials I received in class will be helpful when working with parents. 1 2 3 4

5. This class met my expectations. 1 2 3 4


Documents

fitCare Best Practice Curriculum Facilitation Outline Class #3