Preven&ng Childhood Obesity: Best Prac&ce Strategies in Nutri&on and Physical Ac&vity in Early Learning

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1 Preven&ng Childhood Obesity: Best Prac&ce Strategies in Nutri&on and Physical Ac&vity in Early Learning Cathe Paul, MPH, BSN Katy Levenhagen, MS, RD Coalition for Safety and Health in Early Learning This project was made possible by funding from the Department of Health and Human Services and Public Health - Seattle & King County

2 What are Best Prac&ces? Defined by Caring for Our Children: Preven&ng Childhood Obesity in Early Care and Educa&on Programs, 2010 CFOC = Best Prac&ce Standards for Early Learning

3 Outline for the Day Morning Overview of Childhood Overweight/Obesity Best Prac&ces: Nutri&on and Meal&me Socializa&on Menu Planning and Meal&me Ac&vi&es for Early Learning 10:30 Smoothie Break Lunch - Farm to Workshop Provided by Maya, Our Beginnings Child Care Farm to Child Care Table: Presenta&on by Puget Sound Food Network AUernoon Wellness for Child Care Providers Best Prac&ces: Physical Ac&vity and Screen Limits Physical Ac&vi&es for Early Learning 2:30 Rhubarb/Apple Crisp Break 3:15 Evalua&ons and Wrap- up

4 Childhood Obesity Obese: BMI-for-age and sex > 95 % Overweight: BMI-for-age and sex > 85 % Healthy Weight: BMI-forage and sex between 5th and less than 85th % Underweight: BMI-for-age and sex less than 5th %

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6 How Many Kids in Child Care King County, 2008 Total Centers Family School Age 25,611 17, From Department of Early Learning, Child Care Resources, Regional Infant Toddler Planning Preschool Assessment King County Report, 37, , 10/8/ ,373 11,956 Toddlers Infants

7 Childhood Obesity Rates CDC data, to 5 yrs has more than doubled (from 5% to 10.4%) during the past 3 decades. 6 to 11 yrs has more than quadrupled, during past 4 decades (from 4.2% to 19.6%) 12 to 19 yrs has more than tripled (from 4.6 to 18.1 percent) during the past four decades.)

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9 In Washington State % of low income 2-5 year olds were obese Pediatric Nutri&on Surveillance Report, 2008,

10 Long Term Health Risks Diabetes Type 2 High Blood Pressure/Hypertension High Cholesterol Heart Disease/Stroke Higher health care costs Quality of Life issues

11 Short Term Health Risks Premature puberty Sleep Apnea Asthma Bone/joint issues social discrimina&on Depression and low self- esteem Risk for ea&ng disorders

12 Thirty years ago, most people led lives that kept them at a healthy weight. Kids walked to and from school every day, ran around at recess, participated in gym class, and played for hours after school before dinner. Meals were home-cooked with reasonable portion sizes and there was always a vegetable on the plate. Eating fast food was rare and snacking between meals was an occasional treat. M. Obama, letsmove.gov

13 Contribu&ng Factors Too Many Calories More added fats, sugar and salt Too much food/more snacking Larger servings Lack of family meals Too much sedentary &me/screen &me Lack of enough physical ac&vity Viewing more food adver&sements

14 NHLBI Por&on Distor&on Quiz OEI- NHLBI Slide Show Menu Page hap://hp2010.nhlbihin.net/oei_ss/menu.htm#pd2

15 Healthy Weight for Children Infant Feeding Prac&ces Nutri&on Meal&me Socializa&on Screen Time Limits Physical Ac&vity

16 Childhood Obesity Preven&on Infants and Toddlers Breaseeed Prac&ce cue feeding No TV, computer or media for babies under 2 Provide many opportuni&es for ac&vity across the day

17 Breaseeeding plays an important role in obesity preven&on and improving overall health outcomes, and therefore is vitally important to public health. United States Breaseeeding Commiaee, Chair, Joan Younger Meek, MD, MS, RD, IBCLC, Preven&ng Obesity Begins at Birth through Breaseeeding, Jan. 2011

18 CFOC Standards Infant Feeding Support, encourage and accommodate breaseeeding Moms 18

19 CFOC Standards Infant Feeding Feed according to baby s cues hunger and sa&ety need &me to explore Introduce solid foods: Make a plan with parents Preferably closer to 6 mths as indicated by needs Maa and Baby Ellyn Saaer 19 Oh Baby...Feeding Young Children in Group Senngs

20 Childhood Obesity Preven&on Nutri&on Expose children to a wide variety of foods Eat at home most ouen Limit high calorie, highly processed foods Limit sugar sweetened beverages and juice Strive for 5- A- Day

21 CFOC Nutri&on Standards Serve a 3 component breakfast to all kids 1% milk to kids over 2/whole for kids under 2 Limit juice to < 2, 4 oz glasses a week Limit high fat, sugar and sodium foods Serve a fruit and/or vegetable at snack Supplement parent supplied meals Provide nutri&on/educa&on guidance to parents

22 Low fat, low sodium less added sugar Less processed foods (canned, box, package) More whole foods (fruits, veggies, whole grains) More foods made from scratch Eat 5 servings of fruits and veggies/day

23 ABCs of Menu Planning Nutrient Adequacy and Food Appeal Meet CACFP meal paaern Balance Ensure variety, at least 2 week menu cycle, limit juice to < 2/wk Fruit and veggies for PM snack Calories Serve 1% milk Limit high fat, sugar and sodium foods to < 1/week

24 Rate the Menu

25 Break/Snack

26 We suggest that helping children aaend to internal cues of hunger and sa&ety should be promoted as a produc&ve child- feeding strategy and as an alterna&ve to coercive or restric&ve prac&ces. Susan Johnson, PhD, Improving Prschoolers Self Regula&on of Feeding Pediatrics, 2000

27 Childhood Obesity Preven&on Meal&me Environment Eat together ouen (6-19 yrs) Model healthy ea&ng habits (Preschoolers) Help children self regulate (infancy on) Avoid using food for rewards or punishment (all)

28 Division of Responsibility During Ea&ng Main goal - self regula&on Adults decide what, when, where Kids decide if, what and how much Ellen Saaer, Feeding with Love and Good Sense, Bull Publishing, 2nd Edi&on, 2000 Video Clip: When a parent asks for regula&on University of Idaho - Feeding Young Children in Group Senngs - videos alphabe&cal

29 Sit with kids Eat with kids Role Model Serve family style Let the kids help Follow Division of Responsibility Watch video clips Pouring He s Such a Picky Eater University of Idaho - Feeding Young Children in Group Senngs - videos alphabe&cal

30 I hear and I forget. I see and I remember. I do and I understand and One picture is worth a thousand words.

31 Lunch Time Farm to Child Care Table Puget Sound Food Network Presenta&on with Emma and Karen