Youth Nutrition Program The NCOAI has developed a youth nutrition program with the goal of consolidating the plethora of information concerning childhood obesity and solutions /strategies that can be implemented at the family and school level. This series includes determining children s caloric needs and sample menu plans based on caloric needs.
Call to Action We must all take up the call to action to reduce obesity rates! The purpose of this program is to educate all individuals on: The definition of childhood obesity How childhood obesity is measured The numbers of children that are classified as either overweight or obese The health consequences associated with childhood obesity Understanding serving sizes and portion sizes How to determine caloric needs for children How to implement the NCOAI Children s Menu Plans based on those needs
Childhood Obesity Over the past three decades, childhood obesity rates in the United States have tripled. Today, more than 23 million children and teens are overweight or obese, which places them at increased risk for serious diseases such as diabetes, heart disease, cancer and stroke. If this trend continues, for the first time in history, children will have shorter and less healthy lives than their parents.
Defining Childhood Obesity The terms "overweight" and "obesity" refer to body weight that s greater than what is considered healthy for a certain height. The most useful measure developed thus far of overweight and obesity is body mass index (BMI). BMI is calculated from height and weight. The Center for Disease Control and Prevention provides the following definitions: Underweight: BMI below the 5th percentile Normal weight: BMI at the 5th and less than the 85th percentile Overweight: BMI at the 85th and below 95th percentiles Obese: BMI at or above 95th percentile
Measuring Childhood Obesity BMI What is Body Mass Index? What is a BMI Percentile? How is BMI used with children and teens? How is BMI calculated and interpreted? How is BMI used? Category Underweight Healthy weight Overweight Obese Percentile Range Less than the 5th percentile 5th percentile to less than the 85th percentile 85th to less than the 95th percentile Equal to or greater than the 95th percentile
Rates of Childhood Obesity Currently, nearly 36 percent of adults and 17 percent of children ages 2 to 19 are obese, according to the Centers for Disease Control and Prevention. These figures have more than doubled for adults and tripled among children since 1980. It is not hyperbole to call obesity an epidemic that ultimately manifests itself in increased rates of diabetes, heart disease and cancer. Among preschool children aged 2-5, obesity increased from 5.0% to 10.4% between 1976-1980 and 2007-2008 and from 6.5% to 19.6% among those aged 6-11. Among adolescents aged 12-19, obesity increased from 5.0% to 18.1% during the same period. There are significant racial and ethnic disparities in obesity prevalence among U.S. children and adolescents. Table 2 shows the estimates in obesity prevalence by race/ethnicity for boys and girls since NHANES III (1988-1994). In 2007-2008, the prevalence of obesity was significantly higher among Mexican- American adolescent boys (26.8%) than among non-hispanic white adolescent boys (16.7%). In NHANES III (1988-1994) there was no significant difference in prevalence between Mexican-American and non-hispanic white adolescent boys. http://www.cdc.gov/obesity/childhood/index.html
Health Consequences Some health problems are much more likely to affect obese children than non-obese children: Asthma, especially severe asthma Diabetes, type 2 High blood pressure High cholesterol Heart failure Liver problems ("fatty liver") Bone and joint problems in the lower body Growth abnormalities Emotional and social problems Breathing problems such as sleep apnea Rashes or fungal infections of the skin, acne Obese children also are much more likely to have these and other obesity-related health problems in adulthood: Heart disease Stroke Certain types of cancer Osteoarthritis Gout Gallbladder disease
Diabetes Diabetes is one of the most common chronic diseases in children and adolescents 151,000 people below the age of 20 years have diabetes (Type 2) Taking a worse toll on children than medical experts realized Harder to treat diabetes in children Factors of why children do not respond to treatment unknown Poorly controlled diabetes significantly increases the risk of: Heart disease, eye problems, nerve damage, amputations and kidney failure The longer a person has the disease, the greater the risk So in theory, people who develop diabetes as children may suffer its complications much earlier in life than previous generations who became diabetic as adults
Serving Sizes Grains ½ cup cooked oatmeal (1 ounce equivalent) 1 slice bread, waffle or pancake (1 ounce equivalent) ½ bagel, hamburger bun, or English muffin (1 ounce equivalent) ½ cup cooked rice, pasta or cereal (1 ounce equivalent) 1 cup ready to eat cereal (1 ounce equivalent) 1 ounce whole wheat crackers Milk 1 cup milk or yogurt 2 ounces processed cheese (American) 1 ½ ounces natural cheese (cheddar) 2 cups cottage cheese Meat /Beans /Nuts 1 tablespoon of peanut butter counts as 1 ounce ¼ cup nuts or 20-24 almonds 1 medium size egg 2-3 ounces of poultry, meat or fish (2-3 servings) ¼ cup of beans Vegetables ¾ cup (6 fluid ounces) 100% vegetable juice 1 cup raw, leafy vegetables or salad ½ cup cooked or canned vegetables Fruits 1 medium apple, orange or banana ½ cup fruit (canned, cooked or raw) ½ cup (4 fluid ounces) 100% fruit juice ¼ cup dried fruit (raisins, apricots or prunes)
Portion Sizes Servings Servings /Day One Serving 1-3 years One Serving 4-5 years One Serving 6-12 years One Serving 12 years - adults Grains 5 or less ½ slice or ¼cup ½ slice or 1/3 cup 1 slice or ½ cup 1 slice or ½ cup Vegetables 3 to 5 ¼ cup 1/3 cup ½ cup ½ cup Fruits 2 to 4 ¼ cup 1/3 cup ½ cup ½ cup Dairy 2 to 3 ½ cup ¾ cup 1 cup 1 cup Meat/Beans/Nuts 2 to 3 1 oz or ¼ cup 1 ½ oz or 1/3 cup 2 oz or ½ cup 2 to 3 oz or ½ cup Below is a table listing the number of servings per day based on caloric intake (reprinted from ChooseMyPlate.gov). Calories 1000 1200 1400 1600 1800 2000 2200 2400 2600 2800 3000 3200 Grains 3 oz eq 4 oz eq 5 oz eq 5 oz eq 6 oz eq 6 oz eq 7 oz eq 8 oz eq 9 oz eq 10 oz eq 10 oz eq 10 oz eq Vegetables 1 cup 1 ½ cups 1 ½ cups 2 cups 2 ½ cups 2 ½ cups 3 cups 3 cups 3 ½ cups 3 ½ cups 4 cups 4 cups Fruits 1 cup 1 cup 1 ½ cups 1 ½ cups 1 ½ cups 2 cups 2 cups 2 cups 2 cups 2 ½ cups 2 ½ cups 2 ½ cups Dairy 2 cups 2 cups 2 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups Meat/Bean/Nuts 2 oz eq 3 oz eq 4 oz eq 5 oz eq 5 oz eq 5 ½ oz eq 6 oz eq 6 ½ oz eq 6 ½ oz eq 7 oz eq 7 oz eq 7 oz eq NCOAI has developed easy-to-use menu plans that incorporate the required number of servings per food group!
Children s Caloric Needs Due to the rise in childhood overweight and obesity, health experts are advising: An increase in activity Healthier food choices for children who are overweight, obese A Pediatrician should be consulted Calories should not be restricted as it can interfere with growth/development A pediatrician should be consulted if a child appears to be underweight as well Children burn a large number of calories simply by growing, playing and going about their day-to-day lives. Caloric requirements for children vary according to rate at which they burn calories, their body type and their age. Average calorie needs increase as a child ages, with his peak number of calories--between 2,200 and 3,000 daily calories--during adolescence. Gender Age (years) Sedentary b Moderately Active c Active d Child 2-3 1,000 1,000-1,400 1,000-1,400 Female 4-8 9-13 14-18 1,200 1,600 1,800 1,400-1,600 1,600-2,000 2,000 1,400-1,800 1,800-2,200 2,400 Male 4-8 9-13 14-18 1,400 1,800 2,200 1,400-1,600 1,800-2,200 2,400-2,800 1,600-2,000 2,000-2,600 2,800-3,200
Meeting Children s Caloric Needs Step 1 Step 2 Step 3 - Step 4 Step 5 Step 6 Determine caloric needs based on age, gender and activity level (table below) Determine appropriate menu plans (NCOAI Children s Menu Plans) Print appropriate menu plan If the child is old enough, involve the child by writing down what he/she eats for several days If the child is old enough, ask the child to compare present eating patters with the appropriate NCOAI Children s Menu Plans If the child is old enough, ask how the present eating pattern can be made healthier (several, small, palatable changes) Gender Age (years) Sedentary b Moderately Active c Active d Child 2-3 1,000 1,000-1,400 1,000-1,400 Female 4-8 9-13 14-18 1,200 1,600 1,800 1,400-1,600 1,600-2,000 2,000 1,400-1,800 1,800-2,200 2,400 Male 4-8 9-13 14-18 1,400 1,800 2,200 1,400-1,600 1,800-2,200 2,400-2,800 1,600-2,000 2,000-2,600 2,800-3,200 * For younger children follow the same steps involving the child as much as possible in the decision making process.
Children s Menu Plans 1000 calorie menu plans 1200 calorie menu plans 1400 calorie menu plans 1600 calorie menu plans 1800 calorie menu plans 2000 calorie menu plans 2200 calorie menu plans 2400 calorie menu plans 2600 calorie menu plans 2800 calorie menu plans 3000 calorie menu plans 3200 calorie menu plans Menu Plans are available free of charge
Motivating Children The NCOAI has developed three colorful, laminated, star-associated food tracking placemats to meet the needs of all educational settings. These laminated, reusable, interactive placemats allow children to use enclosed washable markers to color in stars and reward themselves for good decision making! The NCOAI Placemats incorporate a star associated food rating system on the front side of the placemats. Foods are rated according to their nutritional value: 5 stars (Gold) best choices, 4 stars (Green) - good choices, 3 stars (Blue) Ok choices, 2 stars (Red) less healthy choices, and 0 stars (Grey) avoid these choices. Fro more details visit http://www.ncoai.org/placemats/