Nutrition & Physical Activity Guidelines for Adolescents Suzanne Haydu MPH RD Sangi Rajbhandari MPH Abby Silvester (MS Candidate/RD Intern, CWRU) Krista Flores RD Maternal, Child and Adolescent Health Division
Introduction Suzanne Haydu, MPH, RD
Agenda Introduction - Suzanne Haydu, MPH, RD, Nutrition and Physical Activity Coordinator, MCAH/CDPH What s New Sangi Rajbhandari MPH Most Recently Updated Abby Silvester Stories from the Field Krista Flores RD Questions/Answers
Objectives By the end of this webinar you will: 1. Be able to locate the Nutrition & Physical Activity Guidelines and related tools for adolescents on the web 2. Be able to competently use the tools located in the Nutrition & Physical Activity Guidelines when working with adolescents 3. Be especially familiar with the Fruits and Vegetables, Vegetarian Teens & Body Image and Disordered Eating sections
NUPA Guidelines for Adolescents Photo Source: ClipArt
Speakers Sangi Rajbhandari, MPH Abby Silvester MS Candidate Dietetic Intern Krista Flores, RD
What s New Sangi Rajbhandari, MPH
What s New
Updated Content Recent recommendations consistent with national guidance/research Addition of new chapter, Infant Feeding Use of MyPlate
Photographs Included
Colorful Handouts Affixed to the end of each section Made available on a separate webpage http://www.cdph.ca.gov/healthinfo/healthyliving/nutrition/pages/nupaadolescentsguideli neshandouts.aspx
Increased Interactivity Links to outside resources embedded within the guidelines Links to handouts and other sections of the guidelines also included
Web Links Referenced/ Additional Resources Page Specific resources available for each section Additional resources page displays Title of resource Resource type URL (hyperlinks to resource websites)
Recent Sections Abby Silvester MS Candidate Dietetic Intern
NUPA Guidelines Reference and guide for case managers Interventions/Referrals Follow-Up Web Links Referenced/Additional Resources
Nutrition and Physical Activity Screen How to use the screen Use these screens to determine where the client needs improvement When applicable, additional screening available in specific sections
Fruits and Vegetables Vegetarian Teens Body Image and Disordered Eating
Fruits and Vegetables
Inside this Section Why are Fruits and Vegetables Important? Benefits of fruit and vegetable rich diet Why the Concern about Fruit and Vegetable Intake? CalTEENS, 2012 National Youth Risk Behavioral Surveillance System (YRBSS), 2013
Recommendations
Cups or Servings? Recommendation language changed from servings to cups and may be confusing Cups used in 2010 DGA and MyPlate Hyperlinks to resources that contain examples of what counts as a cup
Why do Adolescents Avoid Fruits and Vegetables? Availability Social Norms Perceptions Knowledge and/or Skills Parental Role Modeling
Interventions/Referrals Explanation of how to utilize the handouts Hyperlinks to handouts included
Handouts Fruit and Veggie Quiz Intervention activities Fruit and Vegetable Tips How to incorporate more fruits and veggies in the diet
More Handouts Be Sure to Get your Fruits and Veggies Eat a Colorful Variety of Fruits and Veggies
More Handouts Action Plan for Fruits and Veggies
Vegetarian Teens
Inside this Section What is a Vegetarian Diet? General information The Spectrum of Vegetarian Diets Definitions of common vegetarian diets Vegan / Raw Vegan Semi-Vegetarian
Why Teens Choose to Go Vegetarian Interest in animal rights Religious beliefs Health or wellness To lose weight Popular among friends Fitness Possible association with disordered eating
Nutritional Concerns Vegan diets Protein n-3 Fatty Acids Calcium and Vitamin D Iron Zinc Vitamin B 12 Pregnancy
Nutritional Concerns Table for quick reference Specific vegetarian diet Associated nutrients of concern Some sources of the nutrients
Additional Screening Food Habits screen first from the Nutrition and Physical Activity Screen chapter Is vegetarianism present? Additional screening What specific type of vegetarian diet is being followed?
Interventions Utilize the handouts to encourage a healthy vegetarian diet
Handouts Vegetarian Food Guide Tool to guide healthy vegetarian diet Tips for Vegetarians
More Handouts Smart Choices Activity sheet for teens Vegan Foods with Protein Includes serving size (in cups and ounces) Includes grams of protein each food provides
Body Image and Disordered Eating
Inside this Section What is Body Image? Poor Body Image Influences on Body Image Pressure from parents, teachers, friends Society
Inside this Section Risk Factors for Developing Disordered Eating Family dysfunction Focusing on weight Stress, anxiety, depression Trauma Poor Body Image can Lead to Disordered Eating
Inside this Section Disordered Eating and Exercise Binge eating, anorexia nervosa, bulimia Other Specified Feeding or Eating Disorder Unspecified Feeding or Eating Disorders Orthorexia Nervosa (Orthorexia)
Inside this Section Eating Disorder Warning Signs Common Misconceptions You can tell by looking whether a person has an eating disorder. False. There are many people with eating disorders who are of average weight
Interventions How to Start the Conversation Krista Flores RD Dr. Judith Brisman How to Help Someone
Interventions/Referrals How to use handouts If an eating disorder is suspected, refer to a specialist Hyperlink to Additional Resources page
Handouts What is Body Image? Definition How it is shaped over time Develop a Positive Body Image Activity sheet
More Handouts Ask Yourself The Important People in My Life Accept All Body Shapes
Stories from the Field Krista Flores, RD Eating Recovery Center of California
Eating Disorders and Body Image By: Krista Flores, RD June 25, 2015
Outline How to approach and talk to an adolescent with an eating disorder Signs to Look For Body Image and Disordered Eating Screening Tool What to Say- Step by Step Questions and Answers
How to Approach and Talk to an Adolescent with an Eating Disorder Build rapport = trust and openness Express your concern in a relaxing and calm environment. Eating disorders have the highest mortality rate of any mental illness Discuss your worries sooner rather than later to prevent damaging physical and emotional effects of the eating disorder Know your limits Use your resources and refer
Signs to Look for Focused on weight for sports Dieting Weight changes Negative comments about food/body image Depression Perfectionist Food intake
Screening Tool Use of Screening Tool What to look for How to Interpret http://www.cdph.ca.gov/healthinfo/he althyliving/childfamily/documents/mo- NUPA-02NutritionalRiskScreening.pdf
What to Say- Step by Step Set a time to talk Communicate your concerns Ask the adolescent to explore these concerns Avoid conflicts or a battle of wills Avoid placing shame, blame, or guilt regarding their actions or attitudes Avoid giving simple solutions Express your continued support Body Image and Disordered Eating Handouts http://www.cdph.ca.gov/healthinfo/healthyliving/nutrition/documents/body%20image%20handouts%20may%2029%202015.pdf (National Eating Disorders Association, 2015)
The Frontline The sooner an eating disorder is detected the sooner the adolescent can get treatment and have a better prognosis of recovery The adolescent and/or their family may be resistant to getting their child help Follow up, reassess, review handouts and provide support
Questions?
References National Eating Disorders Association. What should I say. http://www.nationaleatingdisorders.org/what-should-isay. 2015. Accessed July 8, 2015. Prevention of Eating Problems with Elementary Children, Michael Levine, USA Today, July 1998. Shisslak, C.M., Crago, M., & Estes, L.S. (1995). The Spectrum of Eating Disturbances. International Journal of Eating Disorders, 18 (3): 209-219. Zucker NL, Womble LG, Williamson DA, et al. Protective factors for eating disorders in female college athletes. Eat Disorders 1999; 7: 207-218.
Questions?
Suzanne Haydu, MPH, RD Nutrition and Physical Activity Coordinator Maternal, Child & Adolescent Health Division Center for Family Health, California Department of Public Health Suzanne.Haydu@cdph.ca.gov (916) 650-0382 http://www.cdph.ca.gov/healthinfo/healthylivin g/nutrition/pages/teenguidelines.aspx