ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION
@ShawPhotoTomCourse Educators: Thomas Woods, William Eames
BY AMANDA BRODERICK BSc ANutR
BSC HONS Sports Biomedicine and Nutrition
BY AMANDA BRODERICK LESSON: 1
Course Educator:
Amanda Broderick Course Educator
B.A. (Hons.)
Semester 1: Nutrition Through the LifecyclePractical Lesson 2
@ShawNutritionA [email protected]
Nutritional Requirements for Children
Practical Lesson 2 Learning Outcomes:
Practical Advice:
Tackling childhood obesity
Childhood Obesity
Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years
In 2012 >1/3 children and adolescents were overweight or obese
1 in 3 American kids and teens are overweight or obese
In 2010, the number of children overweight was estimated to be greater than 42 million worldwide
Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnoea, and social and psychological problems.
Children and adolescents who are obese are likely to be obese as adults and are therefore more at risk for adult health problems.
The Facts!Childhood
obesity is now the No. 1 health concern among parents topping drug abuse and
smoking (American Heart
Association 2014)
Depression
Low self-esteem
Lack of confidence
Negative body image
Psychological Issues
“Because of the increasing rates of obesity, unhealthy eating habits and physical
inactivity, we may see the first generation that will be less
healthy and have a shorter life expectancy
than their parents
The Truth of The Matter
Parental obesity Unhealthy diet Sedentary lifestyle Socioeconomic background BMI not decreasing as expected in early years Rapid weight gain in the first year- normal weight gain is
6kg in 1st year and 2kg in 2nd, 3rd and 4th years High birth weight Less than 10 ½ hours sleep per night at 3 years old
Children who are obese between 6 months and 5 years of age have a 25% chance of becoming obese adults
• >6 years of age – increases to 50%
Risk Factors For Childhood Obesity
TV and Obesity
In Mexico city, obesity risk increased by 12% for each hour per day watching TV
Physical activity is inversely
associated with BMI change in
girls
Media time (watching TV or videos, playing video or computer games) is directly
associated with BMI change in both sexes
Television viewing causes weight gain by:
Displacing physical activity Increasing energy consumption At risk of advertising for junk
food
Breakfast clubs Usually aimed at all children to avoid
stigmatization of obese children Aimed at decreasing overall fat consumption Increase consumption of fruits and veg Promote physical activity Limit television time Nutrition education Provision of healthy cafeteria lunches A fitness programme Improved playground facilities Extracurricular activities
Healthy Eating in Schools Schemes
Identify if the young person is overweight or obese
Consider intervention or assessment
Assess lifestyle, comorbidities and willingness to change
Steps To Tackling Childhood Obesity
They see ads on TV, the internet, cell phones and more In 2012 average pre-schooler saw 2.8 fast food ads-per-
day Older children saw 3.2 ads per day In 2012 McDonalds ads accounted for >1/3 of fast food
ads viewed Mc Donald's was the only restaurant to advertise more to
children than older age groups Ads on Facebook represented 19% of fast food display
advertising in 2012 $2 billion a year is spent targeting children and teens There is strong evidence that television advertising
influences the food and beverage beliefs, preferences and requests of children (Institute of Medicine, 2006)
Television advertising influences children to prefer and request high-calorie and low-nutrient foods and beverages
How Media Promotes Obesity
Attempts to Combat Childhood Obesity
Diet and Childhood Obesity
High fat dietsRefined carbohydrates (High GI)
Sugar sweetened
drinks
Large portion sizes
Fast Food
Danger Areas
Tackling Childhood Obesity
Parent-child interactions and the home environment can affect behaviours related to risk of obesity
Family life has changed a lot over the past two decades
Trends towards eating out
Greater access to television
Greater social support correlates strongly with participation in physical activity
Children who suffer from neglect, depression, or other related problems are at substantially increased risk for obesity during childhood and later in life
Family Factors
1. If child < 5 years: don’t discuss it with child. Just start making healthy lifestyle changes
2. Make it easy for kids to eat smart and move more
3. Serve regular, balanced family meals and snacks4. Reduce sedentary behaviour: TV, video games,
computer5. Don’t blame the child or make them feel guilty
about their weight- more likely to develop an unhealthy relationship with food
6. A united front- mixed messages from parents confuse matters
7. Focus on the big picture= health not weight8. Compliment good behaviours rather than
weight loss e.g. you run so fast!
Childhood Obesity: Advice for Parents
Do’s and Don’ts for Parents
Eat with child as often as
possible
Develop an eating
routine
Keep diet diary for child and review after a week
Make positive comments about healthy food
Make them eat everything on plate
Pressure them to eat more
Take away a refused meal and offer an alternative
Offer the pudding or sweet course as a reward
Food industries spend enormous amounts of money to promote consumption of high calorie processed foods of poor nutritional quality
Underfunded school districts make money by establishing pouring rights contracts with soft drink companies
Placing vending machines in schools
Sub-contracting lunch programmes to corporate food services to save money
Budgetary pressures lead to reduction or elimination of physical education classes
Parents may work long hours-little time to prepare home prepared meals and supervise sedentary activities
Barriers to Change
Diet and healthy eating habits Physical activity Reducing the amount of time that is spent being
sedentary Strategies for changing the behaviour of the child and all
close family members Behaviour change techniques to increase motivation and
confidence in the ability to change Positive parenting skills Emphasise that all family members need to eat healthily
and be physically active regardless of their weight Information on labelling How to increase opportunities for physical activity Identify activities which the child enjoys where they can
be more active Information for other family members so they can
support the child Ongoing support and follow-up
Multicomponent Care Plan
Checklist:
Any underlying causes of weight issue?
Readiness for change- willingness and motivation
Comorbidities (such as hypertension, hyperinsulinaemia, dyslipidaemia, type
2 diabetes, psychosocial dysfunction and exacerbation of conditions such as
asthma) and risk factors
Psychosocial distress- low self-esteem, teasing and bullying
Family history
Families attitude towards child’s weight
Lifestyle- diet and physical activity
Environmental, social and family factors
Growth and pubertal status.
Weight, measure, determine and record the child’s BMI-offer to do the same
for parents, carers and other family members
Use validated transportable instruments that are regularly calibrated
Assessment of Childhood Obesity
Assess the child’s:
Considerations
Age and stage of life
Gender
Cultural needs and sensitivities
Ethnicity
Social and economic circumstances
Physical and mental disabilities
Considerations for Nutritional Intervention
Include parents
Strong support
Regular physical activity prescription including social support
Factors Predicting Success
Allow flexible approaches to reducing calorie intake
Do not use restrictive and nutritionally unbalanced diets
Encourage children to improve their diet regardless if they lose weight or not
Dietary changes should be age appropriate and consistent with healthy eating advice
** Dietary approach alone is not recommended. Multicomponent intervention needed!
Successful Diet Change
Tailor Dietary Changes to Food Preferences
Encourage healthy eating habits- small changes lead to long term success Increase consumption of fruit, vegetables and whole grain products Begin to include low-fat or non-fat dairy products Choose lean meat, poultry, fish, lentils and beans for protein Serve appropriate portion sizes Increase consumption of water Limit high sugar foods and drinks Make favourite dishes healthier Remove calorie-rich temptations- limit treats Encourage healthier snacks Educate children about the benefits of physical exercise Reduce time spent doing sedentary activities Reaching and maintaining an appropriate body weight is important
Dietary Intervention
Implement Healthy Eating Behaviours
Prevent Weight Gain As Children are Still Growing
Balance energy consumption Vs energy expenditure
Energy is needed for normal growth and development
Do not advise an energy reduction diet without talking to a health care provider
Offer them a diet plan with adequate calories to suit their growth and activity needs
Offer them nutritious meals and snacks
Balance is the Key
Behavioural Therapy
Consider:
Barriers: experience and outcome of previous treatments
Level of risk (based on BMI and waist circumference)
Behaviour change to:
Prioritise: Action plan
Goals Reward systems Remove triggers- stimulus control Self-monitoring Physical Activity Prevention of weight gain Support- to meet long-term needs Provide easy to understand language
Praise children for
changes made & be a
good role model
Increase physical activity
Improve eating behaviour
If the child is not ready to change give them the information on the benefits of losing weight, healthy eating and increased physical activity
Surprise, anger, denial or disbelief may diminish ability or willingness to change
Assess the person’s view of their weight and the diagnosis and possible reasons for weight gain
Explore eating patterns and physical activity levels Explore any beliefs about eating and activity that are
unhelpful to weight loss What has the person already tried- was it successful Assess readiness to adopt changes Assess confidence in making changes
Dealing With Emotions
What if Child is Not Ready For Change?
Try attend all of the sessions live and see your knowledge grow
Assignment 2 will be uploaded on Friday
Lesson 3 will cover Nutrition for Teenagers
Recordings are uploaded within 24 hours of the completion of each live session
Further reading links are available if you wish to learn more
Next Steps
Further Learning
To expand upon the subjects covered in todays lesson:
• Basic nutrition- Diploma in Nutrition
• Weight loss- Ultimate weight Loss Programme
Advanced Course Resources
• Free Short Videos• Topical Items that Pop Up Frequently• Easy way of communicating that free content is
available without spamming you!!!!
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