NS325 Nutrition Across the Life Cycle

1. NS325Nutrition Across the Life Cycle Nancy R. Mears, MS, CHES, PAPHS Unit 4 Seminar

2. Food Acceptance In Children

3. Food Development • The transition from the dependent to independent self feeding occurs over the first two years of life; • Shifts from a single to multiple food sources; • There are increased opportunities for the self-regulation of food intake; • There are new social influences for eating with peers and adult caretakers.

4. Preferences & Aversions • Prefer to eat foods that are familiar. • Born with preference for sweet taste. • Adverse responses to sour and bitter tastes. • Flavor, texture, color, temperature are all important to a foods perceived palatability.

5. Shaping Food Acceptance Patterns • Factors with greatest impact on shaping food acceptance patterns: • Opportunities for repeated exposure to new food • Social context of meals • Associative learning

6. Repeated Exposure • Initial rejection of foods is normal, but parents believe child is a “picky eater”. • Increase the food’s familiarity to learn to accept new foods. • Offer new foods in positive, patient manner. • Repeat foods: At least 8-10 times

7. Social Context • By watching what others eat and don’t eat, children learn which foods are acceptable or not acceptable. • Routine mealtime experiences teach children which food combinations their culture finds acceptable & which are not. • Learn which foods are eaten at which meals.

8. Associative Learning • The pairing of something in the environment with something else, resulting in a new response. • Ex - Conditioned aversion- eat something that makes you sick • Common feeding practices can create conditioned dislikes for healthy foods. • Ex - Use sweet rewards to get kids to eat veggies increase preference for the “reward” food

9. Passing Down Eating Patterns • How parents handle their own food intake has profound impact on their children’s food acceptance, preference and intake patterns. • Children’s food preferences influence not only types of foods that children will consume, but overall quality of diet. • Appetite regulatory mechanism can be turned off by parental practices that focus attention away from internal satiety cues. • Eating all food on plate; portions; when to eat

10. Parents Can Shape Healthy Eating What strategies would you recommend to parents to develop healthy eating patterns in kids?

11. Practical Suggestions to Healthy Eating Patterns • Offer repeated exposure to variety of healthy foods. • Be patient; repeat foods 8-10 times • Start early. Make tasting new foods a pleasant routine. • Parents need to be role models. • Don’t use food as a reward as it will only increase their dislike for the food. • Respect children’s ability to regulate their energy intake. • Do not severely restrict children’s access to sweets/desserts/unhealthier items as restriction may make these “forbidden” foods even more attractive to children.

12. Mealtime with Toddlers

13. Mealtime with Toddlers • As toddlers continue to advance their feeding skills, it is crucial to provide a healthy feeding and eating environment. • Structure at meals can have a significant influence on a child’s eating patterns. • Avoid the philosophy of “clean plate club”

14. Mealtime with Toddlers • Introduce one food at a time in order to avoid confusion or overwhelming the child. • 10 exposures to each new food recommended • Develop positive healthy relationship with all foods. • Offer a variety of healthy foods

15. Promoting Vegetable & Fruit Intake • Add fruit purees to mixes (pancakes, waffles, muffins) • Add fruit purees to yogurt and puddings • Add dried fruits to cereal and trail mixes • Mix vegetable purees in soups and sauces • Take the child to the grocery store to select new fruits and vegetables to try

16. Choking Prevention • Some children may not develop the skill of chewing with a grinding motion until 4 years of age • Cut food into small pieces • Child needs to remain seated when eating • Encourage child to take small bites and avoid overfilling mouth

17. Foods to Avoid to Prevent Choking • Hot dog slices • Carrot rings • Whole grapes • Nuts • Popcorn • Hard candies • Large beans

18. Questions??

19. Common Food Issues Picky Eating • Can be common in toddlers, and may continue throughout childhood • May be their attempt at independence • Avoid punishment or rewards for eating food • Avoid making “special meals” for the picky eater

20. Common Food Issues Grazing • Growing children may not want to stop what they are doing for a meal and can end up grazing • May produce a constant feeling of fullness and cause the child to never eat an appropriate amount at meal, therefore not expanding the stomach size • If a child asks for food or liquids more frequently than 2 to 3 hours, encourage them to wait until the next meal or snack time

21. Health Issues Failure to Thrive • Inadequate physical growth diagnosed by observation of growth over time using a standard growth chart. • Factors • inability to meet calorie needs due to medical conditions • Malabsorption • increased metabolism with specific disease states • food shortage • incorrect mixing of formula • neglect

22. Health Issues Lactose Intolerance • inability or insufficient ability to digest lactose, a sugar found in milk and milk products • Uncommon in healthy infants • Symptoms: stomach pain, flatulence, and loose stools • Many are able to tolerate small amounts • Solid cheese and yogurt are better tolerated • Many lactose-free and low-lactose products available

23. Health Issues Excessive Weight Gain • 10% children 2-5 years old are obese • 20% children 6 – 11 years old are obese • Not just one factor, but a combination of physical inactivity, exaggerated portion sizes, sugar-sweetened beverages, lack of fruits and vegetables, and too much screen time • What can be done??

24. Questions??

25. Role of Parents in Promoting Healthy Nutrition in Early Childhood Eating is a learned behavior of flavor and food preferences. Parents are a child’s first teachers • Modeling – children develop preferences for the foods they see others eating • Self regulation – the ability to regulate volume of food intake is believed to be a normal human inborn error

26. Talking Points Feeding Routine – When and where does your child eat? • Your child should have a regular feeding routine including time and location • Television should be off during meals

27. Talking Points Dietary Variety – What kinds of foods does your child like to eat? • Offer soft veggies, fruits, meats, pasta, etc… so your child can practice picking up and chewing • Limit juice to 4 ounces per day – fruit is a healthier option than juice

28. Talking Points Pleasant Mealtimes – Does your child enjoy mealtimes? • Mealtime should be pleasant and positive eating experience for child and parent/caregiver

29. Talking Points Competing Foods – Does your child receive fatty or sweetened foods and drinks? • If a young child is offered foods such as french fries, chips, donuts, desserts, and soft drinks, they will learn to like and expect these foods instead of healthier foods

30. References Edelstein, S. & Sharlin, J. (2009). Life Cycle Nutrition: An Evidence Based Approach. Massachusetts: Jones and Bartlett Publishers.

31. Questions??