Date post: | 30-Mar-2015 |
Category: |
Documents |
Upload: | nehemiah-roth |
View: | 214 times |
Download: | 1 times |
Whole family nutrition, heart health & meal planning:
focus on differing needs and limited budget
Ruth CharlesConsultant Paediatric Dietitian
Ballinderry Clinic, St. Francis Hospital, Mullingar, Co. Westmeath.www.nutrikids.ie
Ruth Charles MINDI
Life ages and stages
Ruth Charles MINDI
Stage Key drivers for nutrition Nutrition related issues Key nutrients
Infant0-12 months
Growth: linear and weight gainBone HealthBlood Health
AnaemiaFood refusal
CaloriesIron Calcium Vitamin D
FibreToddler1-4
Family DietIndependencePhysical activity
Food refusalDental health
Child5-13
Linear GrowthPeersSport & hobbies
Overweight & obesity Calorie quality
Teen14-18
Growth spurtPubertyMenstruationBone Health
Fad diets ImbalanceDrugs and alcoholRole models +/-
Calorie qualityIronCalcium and Vitamin D
Adult18-51
Weight:heightWaist circumferencePregnancy & lactationPhysical activity
OverweightMetabolic SyndromeIrritable bowel syndromeCancerStrokeCoronary Heart Disease
Calorie qualityFolic acidCalcium and Vitamin D
Over 51 Muscle mass declinesBMR dropsAnorexiaPhysical activity
OsteoporosisFractures
Calorie qualityCalcium and Vitamin D
Ruth Charles MINDI
Nutrient requirements Ireland Infants
NEW RECOMMENDATION Vitamin D3 supplement: Children 0-1 year: 5µg/200 i.u.
Ruth Charles MINDI
Nutrient requirements Ireland
Ruth Charles MINDI
Ruth Charles MINDI
Ruth Charles MINDI
Ruth Charles MINDI
Ruth Charles MINDI
Ruth Charles MINDI
Ruth Charles MINDI
Food refusal• Common• Learned behaviour that’s repeated if the desired result is obtained• Keep trying! 10-15 new food exposures required before acceptance• Do you eat the food? Be a good role model.• Eating at the same time. Eating new foods
together. Sitting together at the table.
Ruth Charles MINDI
Iron deficiency AnaemiaAdults: Red meat 2-3 times a week
Infants & children: Include red meat in the weaning diet from 6 months onwardsAvoid giving tea Avoid too much formula/milk (>6oomls reduces appetite for other food)
Follow on infant formulae
Ruth Charles MINDI
Bone health: Calcium (Phosphorus)
• Dairy: 3-5 servings per day for children. 5 servings a day for teenagers. Pregnant/breastfeeding women 3 servings.
• Serving= glass of milk (1/3 pint or 189 ml), 1 pot of yogurt or a matchbox-sized (1oz) piece of cheese.
• There is relatively no difference in the calcium content between full fat, low-fat and skimmed milk.
Ruth Charles MINDI
Bone health Vitamin DActive form cholecalciferol D3 needed.
Non Food sources:5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back
Dietary sources: Most margarinesSome fortified brands of soya milks, yogurts and desserts – check the labelA few fortified breakfast cereals – check the labelDried skimmed milkFortified yoghurtsEggsOily fish: mackerel, herring, tuna, salmon
Ruth Charles MINDI
Dental Health
The facts
Report of the National Taskforce on Obesity 2005 : 1 in 5 children were overweight
Growing Up in Ireland - Overweight and Obesity Among 9-Year-Olds 2011370,000 Irish Children are Obese.
Girls BoysOverweight Obese Overweight Obese
11.6% 13% 10.5% 9.2%
1 in 4 nine year olds are overweight/obese.
This number increases by 10,000 annually.
The World Health Organization (WHO 1998) report shows that the prevalence of both adult and childhood obesity has reached epidemic proportions worldwide.
Ruth Charles MINDI
The changing shape of Irish children
Ruth Charles MINDI
1 2 3 4 5 6 7 8 9 100123456789
10
Blood glucoseInsulin
What is the Metabolic syndrome?
•Your body becomes resistant to its own Insulin•Your own Insulin becomes ineffective
1 2 3 4 5 60
1
2
3
4
5
6
7
8
9
Blood glucoseInsulin
Ruth Charles MINDI
Waist circumference >37”M, >32”F
Ruth Charles MINDI
Mixing a high with a low GI food reduces the overall GI
Low glycaemic index High glycaemic index
Ruth Charles MINDI
Heart Health
Ruth Charles MINDI
Heart Health
Risk factors
• Male• Family History
• Smoker• Stress• Blood pressure• LDL cholesterol• Weight• Cardiovascular fitness
Ruth Charles MINDI
Making sense of cholesterol and triglycerides
Ruth Charles MINDI
What are “omega” fats?
Cannot be made by the bodyMust be eaten: omega 3 & 6
Reduced risk of coronary heart disease: Reduce the stickiness of bloodThin the bloodProtect blood vessel wallsReduce TriglyceridesReduce InflammationMaintain healthy bone joints
Ruth Charles MINDI
Ruth Charles MINDI
How healthy is your bowel?
What colour is normal?
What’s normal ?
Foods for gut and bowel health
Ruth Charles MINDI
Ruth Charles MINDI
Are you getting enough to drink?
WaterMilkPure JuiceDiluted squash
(Alcohol)(Tea/Coffee)(Fizzy drinks)
Ruth Charles MINDI
Where are we getting our calories from?
Ireland 2012
Carbohydrate (mainly high sugar/refined) Fat (mainly sat-urated)Alcohol
Ireland 1970
Carbohydrate (mainly natural high fibre sources)Fat (mainly natural sources from dairy and meat)Alcohol
Ruth Charles MINDI
Calorie quality: carbohydrate
Ruth Charles MINDI
Calorie quality: Fat• Saturated
• Polyunsaturated/• Monounsaturated• Oily fish 2-3 times per
week.
Ruth Charles MINDI
Calorie quality: alcohol
Low risk weekly guidelines for adults are:up to 14 standard drinks (980 kcals)in a week for women, andup to 21 standard drinks (1470kcals) in a week for men.
1SD=70calories
Ruth Charles MINDI
Ruth Charles MINDI
At least one hour of moderate intensity every day
Ruth Charles MINDI
Common recurring themes A role in
More wholemeal, wholegrain, oats Bowel health, Cholesterol reductionSatisfying hunger, Low glycaemic index
More seasonal multicoloured fruit and vegetables. Natural antioxidants: cancer and heart healthSoluble fibre for bowel health, Water soluble vitamins, Low glycaemic indexValue for money
More fish especially oily sources Omega fats for heart health
Choose lean red meat cuts Haem iron for blood health
More pulses, nuts, seeds Fibre for bowel health, Good source of protein and minerals, Low glycaemic index
More fresh home cooked foodBasic cooking skills
Weight management, Low fat cooking methods, Reduced saltLife skills, Value for money
More water Hydration, Dental health, Satisfying hunger
Dairy is good Bone health, Low glycaemic index, Dental health.Good source of protein. Value for money.
Physical activity Agility, co-ordination, mood, heart health, weight management
Ruth Charles MINDI
Common recurring themes A role in
Less top shelf food pyramid1-2 per week
Improved: Weight management, Heart Health &Dental healthCost of living
Less processed food, ready meals, takeaways. Reducing salt intake, Improved Weight management & Heart HealthCost of living
Less added sugar, less added salt Dental health, glycaemic index,Blood pressure
Alcohol in moderation Improved Weight management & Heart Health & general healthCost of living
Learn to read food labels Making better food choices
Ruth Charles MINDI
Ruth Charles MINDI
Free resources
• www.healthpromotion.ie• www.irishheart.ie/media/pub/kids/on_the_go
_booklet_final.pdf• www.littlesteps.eu• www.fooddudes.ie• www.indi.ie• www.mabs.ie
www.nutrikids.ie
Thank you