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‫به نام اوکه‬
‫از همه اوهام وتصویرات دور‬
‫نور نور نور نور نور نور‬
‫مولوی‬
‫ سال‬12-6‫تغذ يه دركودكان سنين‬
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Feeding school age children&adolescence
•-School-aged children (ages 6 to 12) continue to need healthy foods and nutritious snacks. They
have a consistent but slow rate of growth and usually eat four to five times a day (including
snacks).
•Dependent to family than school
•-Many food habits, likes, and dislikes are established during this time.
•-Family, friends, and the media (especially TV) influence their food choices and eating habits
.
• -School-aged children are often willing to eat a wider variety of foods than their younger
siblings
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• -Eating healthy after-school snacks(sandwiches…….) are important, as these snacks may
contribute up to one-third of the total calorie intake for the day
•. -School-aged children have developed more advanced feeding skills, are better at feeding skills,
and are able to help with meal preparation.
Breakfast is a main meal
Wake up earlier
Always serve breakfast, even if it has to be "on the run." Some ideas for a
quick, healthy breakfast include the following:
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fruit
milk
bagel
cheese toast
cereal
peanut butter sandwich
• Take advantage of big appetites after school by serving healthy snacks
such as the following:
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fruit
vegetables and dip
yogurt
sandwich
cheese and crackers
milk and cereal
• Allow children to help with meal planning and preparation.
• Serve meals at the table, instead of in front of the television, to
avoid distractions.
• Healthy food choices:
• Chronic disease prophilaxis(diabetes.m,malignancies,……
• Carbohydrates 50% ,prot 15% ,fat 30%(10%sat,10%un sat,15%bivalent)
of cal intake
• limit Sweet,fat Diet
• Icrease demand in ca,riboflavin,nicotinic Acid,vit D,…..
• Demand to near to2000Kcal/day (70Kcal/kg/day)
• The food guide my pyramid is a guideline to help you and your child eat
a healthy diet.
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• The food guide my pyramid can help you and your child eat a variety of
foods while encouraging the right amount of calories and fat.
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• Most U.S. professional organizations and governmental agencies recommend
the use of the USDA MyPyramid (www.mypyramid.gov) as a basis for building
an optimal diet for children and adolescents
• MyPyramid is based on the Dietary Guidelines for Americans.
• A personalized eating plan based on these guidelines provide, on all the
essential nutrients necessary for health and growth, while limiting
nutrients associated with chronic disease development.
• MyPyramid is aimed at the general public and differs from previous
versions of the food pyramid in many ways.
• The intent is to primarily use MyPyramid as an Internet interactive tool
that allows customization of recommendations, based on age, sex,
physical activity, and, for some populations, weight and height.
• Print material is also available for families without Internet access
• 1-Proposed daily food intake pattern:
• How many cup(oz) or srv for how much cal
• 2-Energy level for proposed intake pattern:
• Based on sex,age,activity
• Calculation of EER
• 3-Nutritional goal for proposed daily food intake
• For each group (AGE,SEX) how mach vit A E C,……,FE,CA,ZN,…Carbohydrate,fiber,prot,fiber.,,...
4-Nutrient profile of food guide pyramid food groupe and subgroups
Each cup fruit,vegtable,meat,… contain: how much vit a,c,tiamin,B6,B12,….how much ca,Mg,….how much
cal,carbohydrate,prot,fiber,fat,,…
Tables:
• The Food Pyramid is divided into 6 colored bands representing the 5 food groups plus
oils:
• Orange represents grains: Make half the grains consumed each day whole grains. Whole-grain foods include
oatmeal, whole-wheat flour, whole cornmeal, brown rice, and whole-wheat bread. Check the food label on
processed foods - the words "whole" or "whole grain" should be listed before the specific grain in the
product.
• Green represents vegetables: Vary your vegetables. Choose a variety of vegetables, including dark greenand orange-colored kinds, legumes (peas and beans), starchy vegetables, and other vegetables.
• Red represents fruits: Focus on fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group.
Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed
• Yellow represents oils: Know the limits on fats, sugars, and salt (sodium). Make most of
your fat sources from fish, nuts, and vegetable oils. Limit solid fats like butter, stick
margarine, shortening, and lard, as well as foods that contain these.
• Blue represents milk: Get your calcium-rich foods. Milk and milk products contain calcium
and vitamin D, both important ingredients in building and maintaining bone tissue. Use
lowfat or fat-free milk after the age of two years. However, during the first year of life,
infants should be fed breast milk or iron-fortified formula. Whole cow’s milk may be
introduced after an infant’s first birthday, but lower-fat or skim milk should not be used
until the child is at least two years old.
• Purple represents meat and beans: Go lean on protein. Choose low fat or lean meats and
poultry. Vary your protein routine - choose more fish, nuts, seeds, peas, and beans
• It should be noted that a diet based on MyPyramid, in order to provide all
the necessary nutrients
• MyPyramid also provides information on discretionary calories, which are
the foods that are not included in MyPyramid guidelines because of their
low nutritional value, such as sweetened beverages, sweetened bakery
products, or higher-fat meats.
• It allows a very small amount of discretionary calories available each day.
The vast majority of children and adolescents do not consume a diet that
follows the recommendations of MyPyramid.
• In general, intake of discretionary calories is much higher than
recommended, with frequent consumption of sweetened beverages (soda,
juice drinks, iced tea, sport drinks), snack foods, high-fat meat (bacon,
sausage), and high-fat dairy products (cheese, ice cream).
• Intake of dark green and orange vegetables (as opposed to fried white
potatoes), whole fruits, reduced-fat dairy products, and whole grain is
typically lower than recommended.
• Furthermore, unhealthful eating habits—such as larger-thanrecommended portion sizes; food preparation that adds fat, sugar, or salt
• skipping breakfast and/or lunch
• fad diets—is prevalent and associated with a poorer diet quality.
• Therefore, MyPyramid offers a helpful and customer-friendly tool to assist
pediatrician counseling families on optimal eating plans for short- and longterm health.
• Activity is also represented on the pyramid by the steps and the person
climbing them, as a reminder of the importance of daily physical activity
• According to the Dietary Guidelines for Americans 2005, a decrease in energy
intake of 50 to 100 calories per day for children who are gaining excess fat can
reduce the rate at which they gain weight. With this reduction in energy
intake, they will grow into a healthy weight as they age. Help your child to find
higher-calorie foods that can be cut from his/her daily intake
• Nutrition and activity tips
• Try to control when and where food is eaten by your children by providing
regular daily meal times with social interaction and demonstration of healthy
eating behaviors.
• Involve children in the selection and preparation of foods and teach them to
make healthy choices by providing opportunities to select foods based on their
nutritional value.
• For children in general, reported dietary intakes of the following are low enough
to be of concern by the USDA
• : vitamin E, calcium, magnesium, potassium, and fiber. Select foods with these
nutrients when possible.
• Parents are encouraged to provide recommended serving sizes for children.
• Parents are encouraged to limit children’s video, television watching, and
computer use to less than two hours daily and replace the sedentary activities
with activities that require more movement.
• Children and adolescents need at least 60 minutes of moderate to vigorous
physical activity on most days for maintenance of good health and fitness and for
healthy weight during growth.
• To prevent dehydration, encourage children to drink fluid regularly during
physical activity and drink several glasses of water or other fluid after the physical
activity is completed.
• At home, much of what children and adolescents eat is under the control of
their parents.
• Typically, parents shop for groceries and they control, to some extent, what
food is available in the house
• It has been demonstrated that modeling of healthful eating behavior by
parents is a critical determinant of the food choices of children and
adolescents .
• Therefore, pediatric counseling to improve diet should include guiding
parents in using their influence to make healthier food choices available
and attractive at home.
• Regular family meals sitting at a table, as opposed to eating alone, in the
living room, or watching television, have been associated with improved
diet quality, perhaps because of increased opportunities for positive
parenting during meals.
• Such an ideal situation is recommended but a challenge for many families
who, with busy schedules and other stressors, are unable to provide such a
setting.
• Pediatricians should work with families to set realistic goals around these
eating issues.
• . Another parenting challenge is to control the excess appetite of some
children and adolescents
• Useful strategies, when the child is still hungry after a meal, include a 15- to
20-min pause before a 2nd servin
• offering foods that are insufficiently consumed, such as vegetables, whole
grains, or fruits.
• Eating at School
• . children take 1 or 2 meals a day in school. Pediatricians and parents
should therefore keep themselves informed of the school's nutrition
policies and menus in their districts and advocate for improved
standards.
• Where the quality of school nutrition is problematic, a practical
alternative is to suggest that children pack their own lunch from home.
• Eating Out
• The number of meals eaten outside the home or brought home from
take-out restaurants has increased in all age groups population.
• The increased convenience of this meal pattern is undermined by the
generally lower nutritional value of the meals, compared to home-cooked
meal
• Typically, meals consumed or purchased in fast-food or casual restaurants are of
large portion size, are dense in calories, and contain large amounts of saturated
and trans fats, salt, and sugar and low amounts of whole grains, fruits, and
vegetables.
• Although an increasing number of restaurants offer healthier alternatives, the
vast majority of what is consumed at restaurants does not fit MyPyramid.
• Parents can use these opportunities to teach and model healthful choices within
the choices offered.
• an increasing number of meals and snacks are also consumed during peer social
gatherings at friends’ houses and parties
•.
• When a large part of a child's or adolescent's diet is consumed on these
occasions, the diet quality can suffer, because food offerings are typically of low
nutritional value.
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• Parents and pediatricians need to guide d teens in navigating these occasions
while maintaining a healthful diet and enjoying meaningful social interactions
•.
• These occasions often are also opportunities for teens to consume alcohol;
therefore, adult supervision is important
• Most families intend to provide their children with a healthful diet
• The discrepancy between this fact and the actual quality of the diet consumed
by children is often explained by difficulties and barriers for families to make
healthful food choices
• Because the final food choice is made by individual children or their parents,
interventions to improve diet have focused on individual knowledge a behavior
changes, but these have had limited success.
• One of the main determinants of food choice is taste, but other factors also
influence these choices.
• . One of the most useful conceptual frameworks to understand the child's food
environment in the context of obesity illustrates the variety and levels of the
determinants of individual food and physical activity choices.
• Many of these determinants are not under the direct control of individual
children or parents
• Understanding the context of food and lifestyle choices helps in understanding
lack of changes or “poor compliance” and can decrease the frustration often
experienced by the pediatricians who might “blame the victim” for behavior
that is not entirely under their control.
• Marketing and advertising of food to children is a particularly illustrative
aspect of the food environment
• Television advertising is an important part of how children and adolescents
hear about food
• Additional food advertisement increasingly occurs as brand placement in
movies and TV shows, on websites, and even video games.