It is the position of the American DieteticAssociation that children ages 2 to
11 years should achieve optimal physicaland cognitive development, attain a
healthy weight, enjoy food, and reducethe risk of chronic disease through appropriate
eating habits and participationin regular physical activity.
Task 1: Concept DiagramWhy 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 worksheetWork aloneMatch the description to diagnosis or syndrome
Task 2: Answers
Marasmus Kwashiorkor Stunted Underweight Overweight/obese Anemia Rickets Scurvy Pellagra
• 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
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 andtraining to practitioners that provide
nutrition-related services tochildren 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