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The early years of life are a period of rapid growth and a healthy diet is cri2cal for normal
development. During this 2me children establish their ea1ng
behaviours and food preferences
Ensure suitability for 2-‐5 year olds
Ruth Charles RD Oct 2015
Challenges facing 2-‐5 year olds
Ruth Charles RD Oct 2015
Normal growth
Ruth Charles RD Oct 2015
Hse.ie
What’s normal growth ?
Ruth Charles RD Oct 2015
BMI is a beKer indicator of overweight or underweight
BMI = weight (kg) height (m) x height (m)
Ruth Charles RD Oct 2015
• The link between diet and health has long been established, and the behaviour of children during the crucial years of development is key to establishing healthy ea2ng prac2ces for life.
Ruth Charles RD Oct 2015
What does growth tell us?
• A good indicator of well being. • Sensi2ve indicator of health • Early detec2on of abnormal growth allows appropriate nutri2onal or social interven2ons.
• Normal growth can only occur if a child is healthy, adequately nourished and emo2onally secure.
Ruth Charles RD Oct 2015
Human engines need…
Ruth Charles RD Oct 2015
Nurtured growth • Improvements in concentra2on, aKen2on, school aKendance, physical ac2vity and lesson grades have been aKributed to beKer nutri2on. (McPherson et al 1995)
• Children who came to school without breakfast had the poorest aKen2on span and concentra2on levels in the classroom. (Neumark-‐Sztainer et al 1999).
• Obesity epidemic
Ruth Charles RD Oct 2015
Ea2ng behaviour & food preference
• Op2mum growth and development starts pre-‐ concep2on. (The first 1000 days concept).
• Children are dependent on others for the provision of food and nourishment as well as guidance on health and wellbeing.
• Parents are the gatekeepers of nutri2on • Bribing, coaxing or forcing a child to eat is never recommended, nor is the use of food as reward or punishment.
Ruth Charles RD Oct 2015
Healthpromo2on.ie
Ruth Charles RD Oct 2015
Feeding prac2ces that aKempt to control the child’s intake limit opportuni2es for the child to exert self-‐control (Birch & Fisher, 1998).
The caregiver decides when and what, the child decides what and how much. This way the child learns to respond to their own hunger and sa2ety cues
Ruth Charles RD Oct 2015
Lead by example
Ruth Charles RD Oct 2015
• Ea2ng behaviour of people in their environment serves as a model as the child grows older.
• Stable ea2ng environment: – Research indicates that it is beKer for children, when families eat together at the table
– no distrac2ons (TV, radio) – enables a social learning of food preferences including rituals of meal prepara2on and learning about healthy ea2ng (Westenhoefer, 2001).
Ea2ng behaviour & food preference
Ruth Charles RD Oct 2015
Barriers to change
– Making healthy food more available and convenient
– Limi2ng the availability of unhealthy op2ons
– Changing social norms to make it "cool" to eat healthily (Neumark-‐Sztainer et al 1999).
– Led by example – Limi2ng the availability of unhealthy op2ons
– Making healthful food taste and look beKer
– Teaching children good ea2ng habits at an early age
– Teaching children to cook and prepare food • Parents knowledge and skills
Ruth Charles RD Oct 2015
• The media is powerful in influencing food selec2on and health behaviours (Goldberg and Hellwig, 1997, in DoHC, 2005).
• Encourage parents to be aware of the
adver2sing messages rela2ng to food and ac2vity or sedentary behaviour that their child/ren may be exposed to.
• Screen 2me (TV, computers) is not
recommended for under 2s and no more than 1 hour/day for pre-‐schoolers.
• Increasing 2me spent in ac2vity
Ruth Charles RD Oct 2015
Ruth Charles RD Oct 2015
Ruth Charles RD Oct 2015
Nutrient( Recommendations(( ! Reasons!Calcium( Fortified!milk!
Block!cheese.!Natural!yogurt!Unsalted!raw!nuts!Pulses!
Bone!and!dental!health!!
Vitamin(D( Fortified!milk.!Try!including!egg,!oily!fish,!liver!regularly!
Bone!health!&!Immune!function!!
Iron( Red!meat!beef,!lamb,!pork!3(times!a!week.!Portion!the!size!and!thickness!of!his!palm!!Fortified!breakfast!cereal!Dark!green!leafy!vegetables!!
Healthy!blood,!prevents!anaemia!
Omega(fats(( Oily!fish:!tuna,!mackerel,!salmon,!trout!3!times!a!week.!!
Heart!health,!brain!development,!immunity!!
Wholegrains( Wholegrain!no!added!sugar!cereals,!breads!and!grains! Bowel,!heart,!metabolic!health!Fluids( Water!and!milk!are!best.!
!Hydration!and!dental!health.!!
Processed(foods((&(treats(
Avoid! Too!high!in!salt/sugar/saturated!fat/additives.!Affects!dental!health,!reduces!appetite!fornourishing!food,!promotes!sweet!tooth.!!
!
Key nutrients for 2-‐5 year olds
Ruth Charles RD Oct 2015
Ruth Charles RD Oct 2015
Rough 'me Aim
7-‐8am Main meal Breakfast
10am Snack
1230pm Main meal Lunch
2.30pm Snack
5pm Main meal Dinner
7pm Supper snack
Snacks -‐provide extra nutrients in a small amount of food Wholegrain breads and cereals Hummus, tahini, nut buKer Cooked or raw vegetable chunks Fresh or dried fruit Block cheese Egg: hardboiled or in homemade pancake Natural yogurt
Ruth Charles RD Oct 2015
Iron deficiency is the most common mineral deficiency worldwide, with women and children
being the most suscep2ble.
• Causes • Effects • Nutri2onal needs • Menu planning
Ruth Charles RD Oct 2015
• Anaemia is a deficiency of red blood cells. • Reduc2on in oxygen-‐carrying ability • haemoglobin concentra'on < 11g/dl (WHO)
Ruth Charles RD Oct 2015
Causes
reduced produc2on and/or
increased loss and/or
lack of produc2on materials iron, vitamin B12 and folic acid
Ruth Charles RD Oct 2015
Higher risk of anaemia with Prematurity and low birth weight -‐ higher need Possible gastrointes2nal diseases: Coeliac-‐increased losses Exclusive breast-‐feeding beyond six months-‐ low iron content Cow's milk as the main drink before 12 months –low iron content High intake of cow’s milk > 1000ml a day-‐ displaces food Poor diet. Teenage girls: menstrua2on with poor diet Pregnancy: increased demand Older women: caused by losing blood faster (menstrua2on) than the body can remake it (poor diet/extreme training) .
Ruth Charles RD Oct 2015
How much is enough?
Food safety authority of Ireland (1999): Recommended dietary allowances for Ireland. Food safety authority of Ireland; Dublin Ruth Charles RD Oct 2015
Effects in children
Behavioural problems Repeated infec2ons Loss of appe2te Lethargy Breathlessness Increased swea2ng Strange cravings (pica) Growth faltering
Ruth Charles RD Oct 2015
Adults
Ruth Charles RD Oct 2015
Preven2ng anaemia
• Regular food sources of – Iron, Vitamin C, Folate, Vitamin B12
• Cau2on with bran and tea and coffee • Vegetarian and vegan-‐special aKen2on
Ruth Charles RD Oct 2015
Iron
Ruth Charles RD Oct 2015
Iron deficiency Anaemia
Infants & children: Include red meat in the weaning diet from 6 months onwards Avoid giving tea Avoid too much formula/milk (>6oomls reduces appe2te for other food) Red meat 3-‐5 2mes a week
Growing up milk
Pregnancy-‐supplementa2on may be needed
Ruth Charles RD Oct 2015
Ruth Charles RD Oct 2015
Ruth Charles RD Oct 2015
Raw green vegetables, oranges, wholegrain cereals, some for2fied foods such as breakfast cereals and bread.
Supplementa2on before and during pregnancy
Ruth Charles RD Oct 2015
How much does enough look like?
Ruth Charles RD Oct 2015
Healthpromo2on.ie Safefood.eu Fsai.ie Bordbia.ie
Ruth Charles RD Oct 2015