© 2006 thomson-wadsworth chapter 11 children and adolescents: nutrition issues, services, and...

© 2006 Thomson-Wadsworth

Chapter 11

Children and Adolescents: Nutrition Issues, Services, and

Programs


Learning Objectives

• Describe three nutritional problems currently experienced by U.S. children and adolescents.

• Specify four Healthy People 2010 nutrition objectives for children and adolescents.


Learning Objectives

• Discuss four nutrition assistance programs aimed at improving the health and nutritional status of children, including their purposes and types of assistance offered.

• Describe factors that increase the likelihood of obesity in children.


Introduction

• Rates of childhood morbidity and mortality due to infectious diseases have dramatically decreased, but new perils have arisen in the past few decades.

• There has been an alarming increase in the prevalence of overweight and obese children and adolescents.


Introduction

• Children are generally categorized as ages 1 to 11 years, while adolescents are ages 12 to 19 years.


Healthy People 2010 National Nutrition Objectives

• Priority concerns for children and adolescents in Healthy People 2010:– Physical activity and fitness– Nutrition– Dental health


Healthy People 2010 National Nutrition Objectives

• Healthy People 2010 Progress Review– The progress review of Healthy

People 2010 suggests that significant steps be made in order to bring about further progress toward achievement of the objectives that promote healthy weights and food choices in children and adolescents.


What Are Children and Adolescents Eating?

• Children’s eating habits have changed over the past two decades.

• The Healthy Eating Index (HEI), used as an indicator of diet quality, provides an overall picture of the variety and quantity of foods people choose to eat, and their compliance with specific dietary recommendations.



• HEI findings:– Children ages 7 to 9 have a lower diet

quality than younger children.– Most children do not meet

recommended intakes of vegetables or meat.



• The Continuing Survey of Food Intakes by Individuals (CSFII) results indicate that children of all ages, races, and ethnic groups were at risk of inadequate intakes of: – Magnesium– Zinc– Vitamins A and E



• Influences on Child and Adolescent Eating Patterns and Behaviors

• Weighing In on the Problem of Childhood Obesity– Over the past two decades, the

percentage of children who are overweight has nearly doubled and the percentage of adolescents who are overweight has almost tripled.


What Are Children and Adolescents Eating? – Obesity

• Childhood Obesity and the Early Development of Chronic Diseases. – Childhood obesity is associated with

hyperinsulinemia, hypertriglyceridemia, and reduced HDL-cholesterol concentrations.

– Contributing factors include:• Genetic susceptibility to obesity• Lifestyle• Family eating patterns• Lack of positive role models• Inactivity



• Other Nutrition-Related Problems of Children and Adolescents– Undernutrition

• Undernutrition is a problem for children from low-income families and those who have run away from home or abuse alcohol or drugs.

• The common and widespread practice of dieting among adolescents, especially girls, makes them at risk for undernutrition.


What Are Children and Adolescents Eating? – Other Problems

• Iron Deficiency and Iron-Deficiency Anemia– One of the most common nutritional

deficiencies, not only in the United States, but in the world.

• Blood Lead Level– Overall, the percentage of children aged 1

to 5 years with elevated blood lead levels decreased more than 80% between 1976 and 1994.



• Dental Caries– Although dental caries are largely

preventable, it remains the most common chronic disease of children aged 5 to 17 years.

• High Blood Cholesterol– When compared with children in other

countries, children and adolescents in the United States have higher blood cholesterol levels and higher dietary intake of saturated fat and cholesterol.



• Eating Disorders– Anorexia nervosa and bulimia

nervosa may affect about 3% of all teenage girls in the U.S.



• Children with Special Health Care Needs– Children with special health care

needs include those with: • Developmental disabilities• Developmental social needs• Handicapping conditions• Chronic disorders• Chronic illnesses


What Are Children and Adolescents Eating? – Special Needs

• These children are at increased nutritional risk because of factors such as: – Feeding problems– Metabolic aberrations– Decreased mobility– Alternations in growth patterns



• Despite the importance of healthful eating habits, unhealthful eating patterns are becoming more pronounced due to: – Increased independence from parents– Eating away from home– Concern with physical appearance and body

weight– The need for peer acceptance– Busy schedules


Nutrition Education Strategies for Preadolescent Girls

• “Free to Be Me” – A Girl Scout badge program that

helps young girls feel good about their bodies.



• Goals and Objectives– Goal:

• Assess the feasibility and short-term impact of “Free to Be Me”

– Objectives:• Decrease incidence of unhealthful weight control

behaviors• Increase knowledge of media influences on body image

and food choices• Increase the interest in healthful eating and body image• Improve participants’ ability to critically evaluate media

messages• Improve overall body image



• Methodology– 6 90-minute sessions presented

during consecutive bi-weekly Girl Scout meetings

– Activities on: • Body development• Media’s impact on body image and self-

esteem• Combating negative images



• Methodology (continued)– 3-hour training session taught troop

leaders to teach the program– Parental involvement:

• Receiving weekly mailings• Assisting with take-home activities• Preparing healthful snacks• Viewing end-of-session skits



• Results– Group-randomized, controlled study

was designed to evaluate program effectiveness • 12 troops that participated in “Free to Be

Me” • 13 non-participating troops as controls



• Results (continued)– Had a significant influence on media-

related attitudes and behaviors– Modest program impact on body-

related knowledge and attitudes– Apparent immediately after the

intervention, but not at follow-up– Significant changes were not noted

for dieting behaviors



• Lessons Learned– Community nutrition programs may

be successfully implemented within Girl Scout troops.

– Intervention programs for young adolescent girls have the potential to promote a positive body image and prevent unhealthful dieting behaviors.


The History of Child Nutrition Programs in Schools

• Federal programs addressing the nutritional needs of children and adolescents have existed for more than 150 years.


Nutrition Programs of the U.S. Department of Agriculture

• The National School Lunch Program– Helps states make lunches available to

children and encourages consumption of domestic agricultural commodities.

– Lunches must include the following:• 8 ounces fluid milk• 2 ounces protein• ¾ cup serving consisting of two or more

vegetables or fruits or both• 8 servings of bread, pasta, or grains per week



• The School Breakfast Program– Helps states provide a nutritious, nonprofit

breakfast for children.– Breakfast must provide one-fourth of the

daily recommended levels of protein, calcium, iron, vitamin A, vitamin C, and calories.

– Breakfast can be either hot or cold.– Breakfast is served free or at a reduced

price to eligible students.



• The After School Snack Program– This expansion of the NSLP provides

reimbursement for snacks served to children, through the age of 18, in after school educational and enrichment programs.



• The Summer Food Service Program for Children– Provides funds for eligible sponsoring

organizations for the purpose of serving nutritious meals to needy children when school is not in session.

– Sponsoring organizations include:• Residential camps• Youth sports camps• Units of local, county, tribal, or state government



• The Food Distribution Program– Provides commodities to public and

private nonprofit schools that serve meals to students.

– School districts are given an entitlement dollar value based on the number of lunches served during the previous year.


Nutrition Programs of the U.S. Department of Health and Human Services: Head Start

• Head Start provides children form low-income families with comprehensive social, education, health, and nutrition services.

• Eligible children range in age from birth to the age at which they begin school.

• It provides meals and snacks as well as nutrition assessment and education for children and their parents.


Impact of Child Nutrition Programs on Children’s Diets• Despite progress that has

enhanced the nutrition quality of school meals, results of research conducted in the 1990s indicated that school meals were failing to meet certain key nutritional goals.


Impact of Child Nutrition Programs on Children’s Diets• Factors Discouraging Participation in

Child Nutrition Programs– The environment in some schools

discourages students from eating meals provided by the NSLP and SBP...

– ...and encourages food choices and eating habits that are not consistent with the Dietary Guidelines for Americans, such as purchase from competitive foods from vending machines


Impact of Child Nutrition Programs on Children’s Diets• Building Healthful School

Environments– Many states and school districts are

developing policies that limit the sale of competitive foods and less healthy food choices.


Action for Healthy Kids

• Action for Healthy Kids (AFHK) - an integrated, national–state initiative that addresses childhood obesity by focusing on changes in the school environment– Leadership provided by former Surgeon

General David Satcher– Includes a partnership of 40 national

organizations, industry groups and government agencies representing education, physical activity, and health and nutrition



• Goals– Short term - increase the number of health-

promoting schools that support sound nutrition and physical activity in order to slow the rate of increasing overweight among American children

– Long term - play a key role in preventing childhood overweight nationwide



• Objectives– Improving schoolchildren’s eating

habits by: • Increasing access to nutritious food and

beverages on school grounds• Decreasing access to high-calorie, low-

nutrient options• Integrating nutrition education into the

curriculum for all schoolchildren



• Objectives (continued)– Increasing schoolchildren’s physical activity

through: • Physical education courses• Recess• Integration of physical activity into academic

classes• After school and co-curricular fitness programs

– Educating administrators, educators, students, and parents about the role of sound nutrition and physical activity in academic achievement


Empowering Teens to Make Better Nutrition Decisions

• “Food on the Run” – Recognized the importance of

empowering teens to make better decisions about their diet, activity, and health.

– Collaboration among 10 California communities



• Goals and Objectives– Goal: Improve the health of high

school students through: • Promotion of accurate nutrition

information in the classroom • Increased availability of healthful food

options on campus



• Goals and Objectives (continued)– Objectives:

• To create a high school youth advocacy model that motivates students to advocate for more healthful food and physical activity options in their communities.

• To advance locally identified policy and environmental changes that increase the number and promotion of healthful food items and physical activity options on participating school campuses.

• To motivate students to make more healthful food choices and to become physically active.



• Target Audience– Low-income students in high schools

where at least 40% of the students were eligible for free/reduced-price meals



• Rationale for the Intervention– Spectrum of prevention framework – States that the following components are

necessary to effect change at the individual and community levels:

• Strengthening individual knowledge and skills• Promoting community education• Educating providers• Fostering coalitions and networks• Changing organizational practices• Influencing policy and legislation



• Methodology– Each school worked with a coalition of local

organizers, health providers, and private industry to build its program

– Components:• Recruitment and training of 10–20 high school

student advocates• Implementation of at least 7 school-based

activities• At least 2 activities to increase parent awareness

and involvement



• Results– Student surveys and an assessment of the

school environment– Statistically significant increases observed

for: • Physical activity knowledge and attitude • Nutrition knowledge, attitude, and behavior• Healthy eating options • Healthy eating promotional efforts on school

campuses • Physical activity options available to students at

the schools



• Lessons Learned– Student involvement is the key to

offering healthful foods that sell and physical activity classes that are full.


Nutrition Education Programs

• Nutrition education strategies aimed at children or their caregivers are found in both the public and private sectors, and strive to improve eating patterns among children.



• Nutrition Education in the Public Sector– Three nutrition education

programming agencies have been the USDA’s: • Nutrition Education and Training program

(NET) – not reauthorized in 2004• Expanded Food and Nutrition

Education Program (EFNEP)• TEAM Nutrition


Nutrition Education Programs – Public Sector

• The CDC Coordinated School Health Program (CSHP) combines health education and promotion, disease prevention, and access to health and social services in an integrated, comprehensive manner.



• YourSELF


Nutrition education activity from USDA’s YourSELF program (7th and 8th grades)



• Eat Smart. Play Hard.• 5 a Day the Color Way• VERB. It’s What You Do• Powerful Bones, Powerful Girls



• Nutrition Education in the Private Sector



• Keeping Children and Adolescents Healthy– Programs and services designed to keep

children and adolescents healthy can have a lasting effect on the nation’s public health.

– Programming for children and adolescents succeeds when it is fun and informative and when it is geared toward a specific health or nutritional objective, such as weight loss or increased physical activity.



• Keeping Children and Adolescents Healthy (continued)– Involving children and adolescents in

the planning and implementation of a program increases its effectiveness, as does using peer support.

© 2006 thomson-wadsworth chapter 11 children and adolescents: nutrition issues, services, and...

Documents

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