Chapter Five: Promoting Good Nutrition In Child Care

Nutrition Policies Need for policies l Centers are doing a poor job of providing nutrition  Inadequate calories, iron, niacin, and zinc— too much fat  90% of CACFP centers studied fell short of meeting needs  Low degree of staff knowledge has a direct effect on nutrition

l 13 million children in child care get a significant part of their weekday nutrition from there  For children in care all day, 2 of 3 meals are eaten in care l Parents should consider nutritional program of a center when choosing child care

Major Goals for Nutrition Policies l Maximizing Nutritional Status l Minimizing Nutritional Risk l Using Nutritional Education as a Tool l Recognizing Importance of Nutritional Guidelines

Policies Needed l Nutritional Guidelines l Basic Nutrition (Understanding) l Nutritional Challenges l Methods and Practices for Caregivers

Understanding Nutritional Guidelines Dietary Guidelines for Americans l Aim for Fitness  Aim for a healthy weight  Be physically active l Build a healthy base  Let the Pyramid guide your food choices  Eat a variety grains daily, especially whole grains  Eat a variety of Fruits and Vegetables daily  Keep food safe

Dietary Guidelines for Americans (cont’d.) l Choose sensibly  Choose a diet that is low in saturated fat and cholesterol and moderate in total fat  Choose beverages and foods to moderate your intake of sugar  Choose and prepare foods with less salt

Food Guide Pyramid l Level One  6-11 servings; breads, cereals, rice, and pasta l Level Two  3-5 servings; vegetables; 2-4 servings fruits  Five A Day Campaign l Level Three  2-3 servings; milk, yogurt and cheese l Level Four  Fats, oils, and sweets sparingly

Reference Daily Intake l Food Label (see Figure 5-2)  Calories, fat, cholesterol, carbohydrates, protein, Vitamin A, Vitamin B, Vitamin C, calcium, and iron are listed Healthy People 2010 Child and Adult Care Food Program

Energy Nutrients (Macronutrients) l Provide calories  Fats, 9 grams  Proteins and Carbohydrates, 4 grams l Include  Carbohydrates  Fats  Proteins Basic Nutrients

Helper Nutrients (Micronutrients) l Vitamins l Minerals l Water

Energy Nutrients Carbohydrates l First source of energy for the body l Major source of energy for central nervous system l Provide glucose to liver to store for energy l Found in Level One and Level Two foods l Diet should consist of 58% carbohydrates l Too little causes body to use up fat and protein

Fats l Second source of energy l Supplies essential fatty acids for child’s growth l Cushions organs, maintains body temperature, promotes healthy skin, helps carry fat-soluble vitamins, and regulates cholesterol metabolism l Major source—Level Three and Level Four foods l Diet should consist of 30% fats

Types of Fats l Saturated  raises cholesterol  found in animal fats l Monounsaturated  is neutral  found in olives, peanuts, nuts, and avocados l Polyunsaturated  lowers cholesterol  found in plants and plant oils l RDA recommends 10% from each category Adequate fat is necessary

Protein l Third source of energy l Major building block in our bodies, in every cell l Builds new cells, aids in repairing damaged tissue, forms enzymes for digestion, and provides hormones and antibodies that help resist infection l Comes from Level One and Level Three foods

Made of amino acids  Nine are essential  Complete proteins have all nine  Complete proteins come from animal sources  Incomplete proteins have some but not all nine essential amino acids  Foods must be combined properly to provide complete protein

Helper Nutrients Vitamins  assist energy nutrients and aid in metabolism l Fat Soluble  Vitamin A, Vitamin D, Vitamin E, and Vitamin K l Water Soluble  Vitamin B and Vitamin C

Vitamin A Promotes growth, good vision, bones, and skin, and helps heal wounds Sources are yellow, orange and green fruits, and vegetables Considered an antioxidant Vitamin D Needed to help calcium make strong bones and teeth Produced naturally in the skin Sources are sunshine and is added to milk, found in fatty fish, liver, eggs, and butter Fat Soluble Vitamins

Vitamin E Helps preserve cell tissues Protects red blood cells and lungs Is an antioxidant Sources are whole grains and vegetable oils Vitamin K Needed for normal blood clotting Sources are dark green leafy vegetables and whole grains

Water Soluble Vitamins Vitamin B Thiamin  essential for carbohydrate metabolism and functioning of nervous system Niacin  essential for carbohydrate metabolism, fat synthesis, and tissue respiration  4 Ds

Vitamin B (cont’d.) Riboflavin  essential for carbohydrate, fat and protein metabolism; promotes healthy skin, eyes, and clear vision Folacin  required for normal growth; prevents anemia and is important in reproduction Overall sources are grains, green leafy vegetables, meats, nuts, and milk products

Vitamin C Is an antioxidant Helps fight disease and protect against free radicals Assists with formation and maintenance of collagen Helps to heal wounds and maintain healthy blood vessels Stimulates immune system to prevent infection Sources are citrus fruits, cabbage, kales, broccoli, bell peppers, black currants, and turnip greens

Minerals help metabolism and regulate body fluids Calcium  present in all bones and teeth Regulates body systems, promotes nerve transmission and functions in muscle contraction Major source is milk and milk products Minerals

Phosphorus  present in all bones and teeth Transports fat and provides enzymes for energy metabolism Sources are milk products, meat, poultry, fish, and whole grains Iron  combines with protein to form red blood cells and carry oxygen Helps immune system resist infection and enzymes to release energy to body Sources are milk, meat, leafy green vegetables, and whole grains

Sodium  important for fluid balance in body Contributes to nerve stimulation and muscle contraction Sources are salt, baking soda, celery, milk, eggs, poultry, and fish Magnesium  present in bones and teeth Transmits nerve impulses, aids enzymes for energy metabolism, helps muscle contraction Sources are milk, meat, green leafy vegetables, whole grains, and legumes

Potassium  important for protein and carbohydrate metabolism Helps in water balance and transmits nerve impulses Sources are vegetables, fruit juices, and fruits, especially bananas and tomatoes Fluoride  promotes strength of bone and teeth structure Prevents tooth decay Sources are fish and fluoridated water Fluoride controversy

Water Water  necessary to sustain life l 70% of human body is water l Needed for metabolic activity within cells, transportation of nutrients and waste products l Water loss in body due to urination and evaporation  Dehydration can be a major problem for infants and young children l Sources are most foods found in nature and water  Fruits and vegetables are a major source

Childhood Nutritional Challenges l Nutritional challenges can be related to malnutrition or overnutrition

Hunger, Malnutrition, and Their Effects l Hunger = chronic shortage of nutrients l 12 million children experience it in U.S. l Causes  Stunting  Impaired brain functions  Vulnerability to infection and disease l Children with chronic health conditions may be at increased risk for hunger and growth retardation

Parents and caregivers may lack Knowledge of nutrition Time Ability to prepare nutritious meals Prevention strategies Nutrition education A balanced diet of healthy foods Healthy food-preparation methods

Obesity l Most prevalent nutritional disease of children under age 18 years l Excess weight caused by energy imbalance  20% over norm weight l May be ethnically linked  Hispanic, African American, and Native American children have a higher rate of obesity

Some common reasons for obesity l Dietary excess in fats and sugars l Lack of exercise l Too much TV l Poor infant/child feeding practices l Food as comfort l Genetic predisposition

Dental Caries (Cavities) l Foods high in carbohydrates and sugar promote formation of cavities l Fluoride most effective way of preventing cavities l Brushing teeth after meals and not giving juice in bottles help in prevention

Iron Deficiency Anemia l Most prevalent nutritional problem in children in U.S. l Twice as likely to occur in poor families l Children may have trouble concentrating, which may affect brain development l Diets need sufficient amounts of iron to prevent it l Infants need vitamin supplements l Menus at child care need to be checked for adequate iron

Cardiovascular Disease and Hypertension l Too many calories, too much fat, and too much cholesterol l Can lead to development of coronary atherosclerosis or heart disease l Excess sodium and weight can lead to hypertension l Best way to improve risk is to modify child’s diet l Should eat diet high in carbohydrates

Food Allergies l Foods that commonly bring on allergies are milk, peanuts, oranges, wheat, pork, and eggs

l Education l Role Modeling l Supervision Implications for Caregivers

Important to child care for 3 reasons l Most common food allergy (28% over 1 year, 46% under 1 year) l Child care often relies on peanut butter and peanut products as a cheap source of protein for snacks and lunches l Peanut allergy increasing in frequency  Reality Check: Peanut Allergy

l Symptoms more severe than all other food allergies  More emergency rooms visits  More likely to cause death than many food allergies Often unable to breathe

l Make sure parents are asked about this when entering child in child care l Make a careful plan for preventing exposure l Should it occur, have a plan how to deal with it (see pages )