Download Improving the Nutritional Standards of Students in New York Public

Improving the Nutritional Standards of Students
in New York Primary and Secondary Schools
Cheryl Hilliman, RN, MSN, FNP, WCC
Walden University
In partial fulfillment of the requirements for PUBH 8165
Dr. Raymond Thron
July10 2009
Purpose of the Presentation
1. To increase the knowledge and awareness of
the benefits of healthy food choices that are
culturally-appropriate and tailored to specific
students in Primary and Secondary Schools in
Brooklyn, New York.
2. To increase the knowledge and awareness of
the benefits of daily exercise in maintaining good
health among students in Primary and
Secondary Schools in Brooklyn, New York.
Objectives
Objective
1.
To increase students awareness and knowledge of the
components of a healthy diet
2.
To increase the perception about the significant health risks that
are associated with unhealthy eating habits
3.
Increase compliance with diet and physical education regulations
in New York State school system.
4.
To improve communication and collaboration of diet and physical
exercise programs among community members,, community
partners and statewide stakeholders
5.
To implement effectiveness of interventions to improve dietary and
exercise curriculum that will improve health outcomes among
students in New York State.
Intended Audience
Students in New York Primary and
Secondary Schools
Classes K6 – K12
Age Range 9 – 18+ years
Background of the Problem
• Increasing obesity rates are also affecting children and
adolescents in the U.S. The prevalence of obesity
among children and teenagers in the U.S. has tripled in
the past 20 to 30 years to 16.5% among children, aged
6-19 years, and doubled to 10.3% among preschool
children, aged 2-5 years (Hedley et al., 2004). The
prevalence of obesity among elementary school children
in NYS has also increased dramatically between 1988
and 2003-2004. Based on measured height and weight
in 2003, 24% of elementary school children (grades K-5)
in New York City were obese. Recent data indicate that
29.5% of high school students in New York City and
28.3% of high school students in upstate New York are
overweight or obese. As in adults, minority youth are
disproportionately affected by overweight and obesity.
How to Prevent Overweight
Prevention is they key to eliminating obesity.
Recognizing symptoms of a problem
before it actually becomes a problem
defines prevention. There are simple ways
to recognize if your body and health are
deteriorating. Most health related issues
can be prevented and obesity is no
exception.
Preventing Obesity
• Over-eating during childhood days contributes greatly to obesity.
The rate of formation of new fat cells is the fastest during the early
stages of our lives; over-eating will cause a greater rate of formation
which gives rise to fats. However, after adolescence the number of
fat cells does not grow any further. Therefore, over-eating in
children, especially in infancy stages, might have planted the seeds
for obesity for the child in the later stages of his or her life. For those
people who become obese in the middle or old ages, most of the
obesity results from the enlargement of pre-existing fat cells. This
type of obesity is much easier to solve as compared to the ones who
have grown obese since young. Therefore, it is vital to learn how to
prevent obesity in your childhood this will prevent obesity in the
future.
•
I
Knowing the foods you eat and why
you eat them
• In order to know the food that are healthy. In
this presentation we will focus on the
• Dietary Reference Intakes (DRI),
• MyPyramid
• 2005 Dietary Guidelines for Americans,
• Reading food labels,
• Selecting appropriate portion sizes,
• Importance of water in our bodies
• Physical Activities in relation to dietary intake
Nutrient Recommendations
• Standards in the U.S. and Canada are the
Dietary Reference Intakes (DRI)
– A set of four lists of values for measuring the
intakes of healthy people
•
•
•
•
Estimated Average Requirements (EAR)
Recommended Dietary Allowances (RDA)
Adequate Intakes (AI)
Tolerable Upper Intake Levels (UL)
Food groups
• The DRI committee has set values for
–
–
–
–
–
–
–
–
Vitamins
Minerals
Carbohydrates
Fiber
Lipids
Protein
Water
Energy
• These set food values are found in our daily
intake Meat; Milk and milk products eggs;
Grains; Oils; Vegetables; Fruits
Adjusting nutrient intakes
• Within your own age and gender group,
the DRI committee advises adjusting
nutrient intakes in special circumstances
that may increase or decrease nutrient
needs
– Such as illness, smoking, or vegetarianism
The Dietary Guidelines
• The Dietary
Guidelines provide
science-based advice
on dietary
recommendations to
prevent disease
through a healthy diet
and physical activity.
Purpose of MyPyramid
MyPyramid helps individuals use the Dietary Guidelines to:
• Make smart choices from every food group.
• Find balance between food and physical activity.
• Get the most nutrition out of calories.
• Stay within daily calorie needs.
MyPyramid Color bands
• Color bands represent that all
food groups are needed
each day for good health.
Food Groups are Color Coded
FRUITS
VEGETABLES
GRAINS
MEAT FISH PEAS BEANS EGGS
NUTS
MILK AND MILK PRODUCTS
OILS
Foods to we must use in
moderation
What determines the amount of our
food intake?
• Note that if you are physically active each day, you can
afford to eat more calories to meet your energy needs
• The more active you are, the higher the energy
allowance you “earn
• The USDA Food Guide ensures that a certain amount of
each of the five food groups is represented in the diet
• The diet planner begins by assigning each of the food
groups to meals and snacks
• The plan can then be filled out with real foods to create a
menu
• The Daily Values (DV) reflect the needs of an “average”
person. The daily caloric intake for a normal person is
2,000 - 2,500 calories a day
Food Exchange System
• Exchange systems can be useful as a
careful diet planner, especially…
– those wishing to control calories
– those who must control carbohydrate intakes
– those who should control their intakes of
protein and saturated fat
OUR CULTURES DETERMINE
HOW WE EAT
MEXICAN
US DEEP SOUTH DIET
Controlling your calories
• To control calories using the diet planner you must
learn the serving equivalents
• The trend in the U.S. has been toward consuming
larger food portions
– Especially foods rich in fats and sugar
• Body weights have been creeping upward
– Suggesting an increasing need to control portion sizes
Restaurants often deliver help to ensure repeat business
• a server on a cafeteria line may be instructed to deliver the
amount that is specific to the person’s needs
• fats-food burgers range from one-ounce child-sized burgers to
a three-quarter-pound triple deluxe
Controlling your portion size and
counting your calories
Controlling your portion size and
counting your calories
Controlling your portion size and
counting your calories
• Among volumetric measures, 1 “cup”
refers to an 8-ounce measuring cup, filled
to level
• Tablespoons and teaspoons refer to
measuring spoons, filled to level
• Ounces signify weight, not volume
Exchange systems
• Exchange systems can be useful in when
using a diet planner, especially…
– those wishing to control calories
– those who must control carbohydrate intakes
– those who should control their intakes of fat
and saturated fat
Exchange systems
• The exchange system highlights a fact that
the USDA Food Guide also points out:
– Most foods provide more than just one energy
nutrient
– The focus on energy nutrients leads to some
unexpected food grouping in the exchange
lists
• High-fat meats and many cheeses are listed
together as “high-fat meats”
• Fat constitutes the predominant form of energy in
these foods, followed by protein
Exchange systems
• An exchange system lists the estimated
carbohydrate, fat, saturated fat, and
protein contents of food portions, as well
as their caloric values
– With these estimates, exchange system users
can make an educated approximation of the
nutrients and calories in almost any food they
might encounter
Food Labels
• In addition to required information, labels
may make optional statements about the
food being delicious, or good for you in
some way, or a great value
– Some of these comments are reliable
– Many others are based on less convincing
evidence
Reading Food Labels
Things that you will find on food labels
– The common or usual name of the product
– The name and address of the manufacturer, packer, or distributor
– The net contents in terms of weight, measure, or count
– The nutrient contents of the product
– The ingredients, in descending order of predominance by weight
Only the top portion of the panel conveys information specific to the
food inside the package
– The bottom portion is identical on every label
– It stands as a reminder of the Daily Value (DV)
What Food Labels Must Include
– Not every package need display information
about every vitamin and mineral
• A large package must provide all of the information
listed on the previous slide
• A smaller label provides some of the information in
an abbreviated form
Food Labels Must Include About
Serving Size and Calories from Fat
• Serving size
– Common household and metric measures allow
comparison of foods within a food category
– This amount of the food constitutes a single serving
and the portion that contains the nutrient amounts
listed
– As of 2005, serving sizes on labels are under review
Servings per container
– Number of servings per box, can, package, or other
unit
• Calories/calories from fat
– Total food energy per serving, and energy from fat per
serving
Food Labels Must Include About
Serving Size and Calories from Fat
• Nutrient amounts and percentages of daily values
– Total fat. Grams of fat per serving with a breakdown showing
grams of saturated fat and trans fat per serving
– Cholesterol. Milligrams of cholesterol per serving
– Sodium. Milligrams of sodium per serving
– Total carbohydrate. Grams of carbohydrate per serving
• Including starch, fiber, and sugars
• With a breakdown showing grams of dietary fiber and sugar
• The sugars include those that occur naturally in the food plus any
added during processing
• The terms “net carbs,” “impact carbs,” and related terms have not
been defined scientifically
– May appear on a label to imply that a food contains less digestible
carbohydrate than similar foods (this may or may not be the case
The label must state the contents of these nutrients
expressed as percentages of the Daily Values
• The label must state the contents of these nutrients
expressed as percentages of the Daily Values
–
–
–
–
–
Vitamin A
Vitamin C
Calcium
Iron
Some, such as those for fiber, protein, vitamins, and most
minerals, are akin to other nutrient recommendations
• They suggest an intake goal to strive to reach
– Other daily values, such as those for cholesterol, total fat,
saturated fat, and sodium, constitute healthy daily maximums
– Nutrient claims on food labels
• If a food meets specified criteria, the label may display certain
approved nutrient claims concerning the product’s nutritive value
Food labels
Getting a
Feel for the
Nutrients in
Foods
Food Feature: Getting a Feel for
the Nutrients in Foods
Water
• The body needs more water per day than
any other nutrient
– One can survive a deficiency of any other
nutrient sometimes for months or years
– One can only survive a few days without
water
– In less than a day, a lack of water alters the
body’s chemistry and metabolism
Water
• Water makes up a large amount
of our body weight
• Water is found in
– Blood vessels
– Cells
– Chemical structure of cells, tissues, organs
• Water participates in many chemical
reactions
Why Is Water One of the Most
Important Nutrient?
• Delivers nutrients and removes waste from
cells
• Water is a, nearly, universal solvent
– Dissolves amino acids, glucose, minerals, etc.
for transport
– Fatty substances are packaged with watersoluble proteins for transport in the blood and
lymph
Water acts as a cleansing agent
in our bodies
• Water is the body’s cleansing agent
– Nitrogen wastes, produced during
metabolism, dissolve in blood and must be
removed before they build up to toxic levels
– Kidneys filter these wastes from the blood
and, mixed with water, excrete them as urine
• Diseased kidneys cannot perform this function that
is the reason why dialysis is necessary for such
persons
The Body’s Water Balance
• Water balance
– Water intake needs to be equal water loss
Otherwise dehydration or water intoxication can occur
Dehydration
– Water loss
– Progression of symptoms: thirst  weakness  exhaustion and
delirium  death
• Water intoxication
– Dangerous dilution of body fluids resulting from excessive water
ingestion
– Symptoms: headache, muscular weakness, lack of
concentration, poor memory, loss of appetite
Importance of Physical activities
• Note that if you are physically active each
day, you can afford to eat more calories to
meet your energy needs
• The more active you are, the higher the
energy allowance you “earn”
In addition to setting nutrient standards,
experts around the world recommend daily
physical activity to help people stay
healthy and live long
Importance of Physical activities
• The American College of Sports Medicine
(ACSM) makes these minimum
suggestions to maintain a healthy body:
– Engage in physical activity every day
– Exercise at a comfortable level
– Exercise for a duration of at least 30 minutes
total per day
Benefits of Fitness
• People who regularly engage in just
moderate physical activity live longer on
average than those who are physically
inactive
• A sedentary lifestyle with smoking and
obesity combined are risk factors for
developing cardiovascular disease, some
forms of cancer, stroke, diabetes, and
hypertension
Benefits of Fitness
– Improved body composition
• A balanced program of physical activity limits body
fat and increases or maintains lean tissue
– Improves bone density
• Weight-bearing physical activity builds bone
strength and protects against osteoporosis
– Enhanced resistance to colds and other
infectious diseases
– Lower risk of some kinds of cancer
• Lifelong physical activity may help to protect
against colon cancer, breast cancer, and some
other cancers
The Essentials of Exercise
• Flexibility
– The capacity of the joints to move through a
full range of motion
– The ability to bend and recover without injury
• Muscle strength
– The ability of muscles to work against
resistance
The Essentials of Exercise
• Muscle endurance
– The ability of a muscle to contact repeatedly
within a given time without becoming
exhausted
• Cardio-respiratory endurance
– The ability to perform large-muscle dynamic
exercise of moderate-to-high intensity for
prolonged periods
Benefits of Fitness
– Stronger circulation and lung function
– Lower risks of cardiovascular disease
• Physical activity lowers BP, slows resting pulse
rate, lowers total cholesterol, and raises good
cholesterol
– Reducing the risk of heart attack and strokes
• Some research suggests that physical activity may
also be of benefit by reducing intra-abdominal fat
stores
Exercise and Physical
• Fitness depends on a certain minimum
amount of
– Physical activity
• Bodily movement produced by muscle contractions
that substantially increase energy expenditure
– Exercise
• Planned, structured, and repetitive bodily
movement that promotes or maintains physical
fitness
Students Learning Activities
Activity #1 Interactive activities selecting
portion sizes
Activity # 2 Group Presentation – Members of each group would
present one or two of their cultural dish, state the various
type of nutrition it contains and when the dish is used
Activity # 3 URL Link Reading food Labels and making choices in
selecting which of the food selected is better and reason
why they are better
Activity # 4 Evaluating foods served in the schools’ cafeteria and
discussing findings with group
Activity # 5 Evaluating snacks served in the school’s vending machine and (a)
discussing findings with group and (b) stating the actions that
should be taken to ensure vendors change the types of foods they
put into the vending machines.
Activity # 6 Contacting vending machine owners demanding them to change
the content of the vending machine to foods with more nutritional values
Learning Materials
• Plastic foods representing sources of each
food group
• Computers for interactive exercises
• Videos
Source
• Sizer, F. and Whitney, E. (2008). Nutrition:
Concepts and Controversies. (11th ed.).
Minneapolis: West Publishing.
• NYS, Pediatric Nutrition Surveillance System
(PedNSS), 2003 NHANES, 1999-2002, J Am
Med Assn 2004; 291: 2847-2850.
• NY U.S. BRFSS 2003, age-adjusted to the 2000
U.S. population. NHANES 1999-2002; J Am Med
Assn 2004;291:2847-2850
2005 Dietary Guidelines
• www.mypyramid.gov/kids -