1. The Downfall of a Girl’s Diet Dr Bob Murray Nationwide Children’s Hospital

2. Childhood Obesity Now

3. Children are Overweight and Undernourished Calcium Folate % Children Consuming Daily Recommended Intake Magnesium Vitamin A Vitamin C Zinc Iron Phosphorus Critical Age Data compiled by Dr. John Lasekan, Ross Labs from NHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998 NHANES, CFSII data compiled by Dr. John Lasekan, Ross Labs Data compiled by Dr. John Lasekan, Ross Labs from NHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998

4. Missing Nutrients Missing Nutrients High School Students Males Vit A, Vit C, Vit E Magnesium, potassium Fiber Calcium Females Vit A, Vit C, Vit E Magnesium, potassium Vit B-6 Folate Thiamin Iron Phosphorous Zinc Fiber Calcium Clark, Fox, JADA 2009; s44

5. The U.S. Dietary Guidelines Food intake is based on daily activity Meals and snacks –Vegetables –Fruits –whole grains –Low-fat milk and dairy –Quality proteins To make every calorie count, choose nutrient rich foods

6. Activity Level Females Age (years) SedentaryPretty ActiveVery Active Calories 4-8 9-13 14-18 19-30 31-50 1,200 1,600 1,800 2,000 1,800 1,400-1,600 1,600-2,000 2,000 2,000-2,200 2,000 1,400-1,800 1,800-2200 2,400 2,400 2,200 a Activity = Calories

7. What are the Right Amounts? 9 year old with moderate activity 1400 - 1600 calories –Breakfast 400 calories –Lunch400 calories –Dinner 500 calories –Snack200 calories 1500 calories

8. Naturally Nutrient Rich the basics of nutrition

9. Focus on fruits. Vary your veggies. Get calcium-rich foods. Make half your grains whole. Go lean with protein. Know the limits on fats, salt, and sugars. Naturally Nutrient Rich US Dietary Guidelines Current Children’s Diet

10. Kids & Snack Foods Snack foods and drinks = 1/3 of daily calories 2/3 of this comes from added sugar ½ of the sugar comes from sweet drinks Which account for 10% of daily calories NHANES III, Kant Arch Ped Adol Med 2003; 157:789

11. BeverageOuncesCalories Water, diet cola20 0 Milk, fat free 8 80 Orange juice 8110 Gatorade20130 Grape juice 8150 Snapple16220 Coke, 7-up20250 Biggie Coke32310 TCBY fruit smoothie20410 7-11 Big Gulp44410 McD’s Vanilla shake16580 Nutr Action Letter, June 2006

12. BEVERAGE CONSUMPTION per person Source: USDA, NMPF gallons

13. Milk’s Nutrients Calcium (30% DV*) Potassium (11% DV) Phosphorus (20% DV) Protein (16% DV) Vitamin A (10% DV) Vitamin D (25% DV) Vitamin B12 (13% DV) Riboflavin (24% DV) Niacin (10% DV)

14. Calcium and Bone

15. MyPyramid: Dairy products 3-a-Day = cups of fat-free or low-fat milk or dairy –2 to 8 years old2 cups per day –9 to 18 years old 3 cups per day 8 oz. milk 1 cup yogurt 1½ oz. natural cheese 2 oz. processed cheese

16. Bone Grows Most in Teens 2 6 10 20 years Bone Thickness 1 m2 y18 y

17. Kids Don’t Get Enough Calcium AgeMaleFemale 6-11 y44%58% 12-19 y64%87% >20 y55%78% BUT

18. Too Many Children Avoid Dairy Low daily calcium –Take in only 400 mg –Need 1300 mg Reasons given –Feel bad tastelifestyle More broken bones Black et al, Am J Clin Nutr 2002; 76:675

20. More Snacks, More Calories TotalMALESFEMALES 0 Snacks11%2156 kcal1501 kcal 1 Snack25%2391 kcal1812 kcal 2 Snacks26%2505 kcal1944 kcal 3 Snacks19%2916 kcal2136 kcal 4 Snacks18%3249 kcal2437 kcal Sebastian, J Adol Health 2008; 42:503 “GRAZING is the new norm”

21. Snacks are Low Quality Food FOOD GROUPSSNACKS Grainschips, puffs, breads, cookies Vegetablespotato chips, pizza, french fries FruitsOJ, apples, non-citrus juices Milkwhite, flavored, frozen dairy Meat/beanshot dogs, lunch meats Oilscorn chips, puffs, potato chips Solid fatsfrozen dairy, cookies, milk Added sugarssoft drinks, fruit drinks, candies Sebastian, J Adol Health 2008; 42:503

22. “Avoidance” is Not Enough Has created a wrong idea: Few “bad” nutrients = a good food

23. Less fat, fewer calories, but NOT more nutrients Does it deserve this?

24. Read the Whole Label

25. The Baby with the Bathwater?

26. Simple – Fun -- FREE Go to www.snackwise.org For Smarter Snacking

27. NOT DIETS

28. The Most Important Things Limit sweetened beverages Eat 5 servings per day of fruits & vegetables Eat a nutritious breakfast every day Limit portion sizes Have regular family meals Limit screens to a maximum of 2hrs No television in the bedroom Moderate to vigorous physical activity for 60 mins/ day