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It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. Task 1: Concept Diagram Why is nutrition in kids important? Groups of 4 Draw a concept diagram Consider the ADA position and AAP article excerpt provided Include possible consequences, causes, contributors Most circles = Prize Pediatric Nutrition Amanda Cuda, MD Objectives Developed concept of pediatric nutrition Reviewed pediatric malnutrition syndromes Reviewed age specific recommendations Explored health behavior counseling Exposed to national and local resources Take Home Inspiration Choose Your Plate Task 2: Matching Malnutrition Syndromes Use worksheet Work alone Match the description to diagnosis or syndrome Task 2: Answers • • • • • • • • • Starvation Protein energy malnutrition Low height for age Low weight for height High weight for height Iron deficiency Vitamin D deficiency Vitamin C deficiency Niacin deficiency Marasmus Kwashiorkor Stunted Underweight Overweight/obese Anemia Rickets Scurvy Pellagra Age Specific Nutrition • Prenatal – Primordial prevention – Iron supplementation if anemia – DHA = Evidence Grade C • Birth – 2 years – Exclusive breastfeeding for first 6 months – Transition to other food sources at 4-6 months – Iron supplementation if anemia at 12 months – Fluoride supplementation if not in water supply and have teeth – Primordial prevention Age Specific Nutrition • 2-5 years – Brushing = may not need fluoride any more – Most do not need multivitamin – Calcium, vitamin D, fiber in diet – Vitamin A supplementation considered in developing countries – Primary prevention – DHA? • 5-11 years, Adolescence – Primary prevention – Fiber http://www.choosemyplate.gov/healthy-eating-tips/ten-tips.html http://www.healthychildren.org/English/ages-stages/Pages/default.aspx http://www.eatright.org/kids/ Task 3: Choose Your Plate • • • • • • • Groups of 4 Menu from Pediatric Inpatient Nutrition Care Bag of “food” Task 3a: Order 3 meals by circling choices Task 3b: Create a meal with food Take 10 minutes We will hear a sample Low hanging fruit • • • • • • • Replace SSB with H2O Avoid the “whites” Eat on a kid plate Eat together at home Take out or fast food 1/week Shop on outside of grocery store 1 fruit, 1 veggie at every meal For Picky Kids • Chocolate milk increased calcium • Presweetened cereals increased calcium, folate, and iron • SSB, sugars, sweets, and sweetened grains had a negative impact • More sugar consumed = fewer vegetables, fruits, dairy, vitamin A, calcium, folate Role of the RD Provide technical assistance and training to practitioners that provide nutrition-related services to children and adolescents in health and education settings. Nutrition Consults • Lisa Lumpkin: 968-0547 • Janet Fabling: 4N/PICU • Individual visits for kids • Special needs over 18 years Objectives Develop concept of pediatric nutrition Review pediatric malnutrition syndromes Review age specific recommendations Explore health behavior counseling Expose to national and local resources Task 4: Take Home Challenge Apply 1 of the “low hanging fruit” health behaviors for 1 month Questions? References • • • • • Stang J, Bayerl CT; American Dietetic Association. Position of the American Dietetic Association: child and adolescent nutrition assistance programs. J Am Diet Assoc. 2010 May;110(5):791-99. Frary CD, Johnson RK, Wang MQ. Children and adolescents’ choices of foods and beverages high in added sugars are associated with intakes of key nutrients and food groups. J Adolesc Health. 2004;34:56-63. Ponza M, Devaney B, Ziegler P, Reidy K, Squatritio C. Nutrient intakes and food choices of infants and toddlers participating in WIC. J Am Diet Assoc. 2004; 104(suppl 1):S71-S79. World Health Statistics 2012, World Health Organization. http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_TOC. pdf Gidding etal. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics 2006;117;544 DOI: 10.1542/peds.2005-2374