www.HealthyKidsHealthyFuture.org

1. Technical Assistance Workshop Honolulu, Hawaii March 8, 2013 Dr. Caree Jackson Cotwright, CDC DNPAO Disclaimer: The findings of this presentation are the conclusions of the presenter and do not necessarily represent the official policies of the CDC nor does the mention of any names or organizations imply endorsement by the Federal government. www.HealthyKidsHealthyFuture.org

2. What is Let’s Move! Child Care? • One component of the First Lady’s Let’s Move! initiative to solve the obesity problem • Supports providers to adopt best practices for physical activity, screen time, foods, beverages, and breastfeeding through free resources and interactive, online tools • Recognizes providers who meet best practices

3. Why Participate? • You can make a difference • You can be a champion for healthy choices • You’re a role model • You care • You’re a partner in parenting • It’s easier than you might think

4. Icebreaker: Rainbow Run • When I call out one of the colors of the rainbow run and touch 3 things that are that color.

5. Session Agenda • Basics about Childhood Obesity • Overview of Let’s Move! Child Care (LMCC) • Physical Activity Focus • LMCC Resources • LMCC Quiz & Action Planning • Tips from Providers that Work! • Technical Assistance and Workshop Feedback

6. Session Objectives After participating in the workshop participants should be able to answer the following questions: • What are the best practices for obesity prevention in ECE? • What are the key challenges I should consider before developing an action plan to address obesity in ECE? • What steps should I take to meet the 5 LMCC goals? • How can I use the tools and resources in the LMCC technical assistance toolkit to improve nutrition, physical activity, screen time and breastfeeding support?

7. Basics about Childhood Obesity Dr. Caree Jackson Cotwright Centers for Disease Control and Prevention

8. Photo source: www.obesityinamerica.org Obesity Common Costly Solvable

9. Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

10. Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

11. Obesity Trends* Among U.S. AdultsBRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

12. We Are Evolving

13. Childhood Obesity • 24% - 33% of 2 – 5 year olds are overweight or obese. • Obesity rates for young children doubled in about a 20 year period of time (1980’s – 2000). • Obese children are more likely to become obese adults. • If children are overweight, obesity in adulthood is likely to be more severe.

17. Education Consequences Children who are overweight or obese can be undernourished at the same time. • Nutrition deficiencies • `Impair brain development and cognitive functioning, including learning • Physical inactivity • Activity promotes brain development, improves sleep, builds self confidence, and reduces stress & depression • Children who are not active have more behavioral and disciplinary problems, shorter attention spans in class and do worse in school compared to active children

18. You Play an Important Role in Preventing Obesity!

19. Moving Forward to Reverse the Obesity Trends “ … we know the cure for this. This isn't like putting a man on the moon or inventing the Internet - it doesn't take some stroke of genius or feat of technology. ... Rarely in the history of this country have we encountered a problem of such magnitude and consequence that is so eminently solvable.” Michelle ObamaFebruary 9, 2010

20. Why obesity prevention in child care and early education programs? • You can help children build healthy habits for life • Food preferences and physical activity habits develop during early childhood and continue into adulthood • You are a role model. Kids do as you do, especially when they’re young. • You are in a unique position to educate parents about healthy eating and activity

21. What You Can Do to Prevent Obesity

22. Moving Forward, Reverse the Trend “ … we know the cure for this. This isn't like putting a man on the moon or inventing the Internet - it doesn't take some stroke of genius or feat of technology. ... Rarely in the history of this country have we encountered a problem of such magnitude and consequence that is so eminently solvable.” Michelle ObamaFebruary 9, 2010

23. Making a Difference Video:

24. Break Time! • Leave the room like the motions of weather in: • Rain • Wind • Thunder • Snow • Sunshine

25. Let’s Move! Child Care Goals

26. 5 Goals Provide 1-2 hours of physical activity throughout the day, including outside play when possible. 1 Physical Activity 2 Screen Time No screen time for children under 2 years. For children age 2 and older, strive to limit screen time to no more than 30 minutes per week during child care, and work with parents and caregivers to ensure children have no more than 1-2 hours of quality screen time per day (as recommended by AAP). 3 Nutrition Serve fruits or vegetables at every meal, eat meals family-style whenever possible, and don't serve fried foods. 4 Beverages Provide access to water during meals and throughout the day, and don't serve sugar-sweetened drinks. For children age 2 and older, serve low-fat (1%) or non-fat milk, and no more than one 4- to 6-ounce serving of 100% juice per day. 5 Infant Feeding For mothers who want to continue breastfeeding, provide their milk to their infants and welcome them to breastfeed during the child care day. Support all new parents' decisions about infant feeding.

27. Stand Up & Talk Time! (2 minutes) Turn to your neighbor and discuss which goals are easiest or hardest to adopt in your ECE setting.

28. Why Offer Healthy Food?

31. Food (1) • Helps children stay at a healthy weight • Food preferences develop at an early age, even in infancy • Opportunity to teach kids’ taste buds to appreciate healthy foods

32. Food (2) • Many healthy options cost the same as the not-so-healthy choices (like whole wheat bread vs. white bread) • Many children eat most of their daily meals and snacks while in care, especially children in full-time care

33. Food (3) Benefits of family-style dining • Improve skills for self-feeding and recognition of hunger cues • Promotes and supports social emotional, and motor skill development • Language skills improve as adults and peers talk with each other • Opportunity for positive role modeling • Adults at the table help prevent fighting, feeding each other, potential choking, and other negative behaviors

34. Food Moves! • Pretend to move like different foods • Melt like a popsicle • Pop like popcorn • Wiggle like spaghetti

35. Why Offer Healthy Drinks?

38. Beverages (1) • Water keeps kids hydrated best • Water helps to reduce acid in the mouth that can cause cavities • Sugary drinks are high in calories and low in nutrients • Drinking water instead of sugary drinks reduces the amount of calories children consume

39. Beverages (2) • Serving fresh fruit instead of fruit juice is best, because it is high in dietary fiber and is a natural source of energy • Skim or 1% milk have the same amount of calcium and other essential nutrients as whole milk, but less fat and calories

42. Reasons for Reducing Screen Time • Gets in the way of exploring, playing, and social interaction. • As kids get older, screen time can get in the way of being active, reading, doing homework, playing with friends, and spending time with family. • Kids who spend more time watching TV are more likely to be overweight or obese.

43. When screen time is allowed: • Make it “quality programming” by choosing shows or computer games that are educational or get kids moving. • Track screen time with a simple scheduling sheet so you know how much screen time a child has and when they’ve reached their limit for the week. • Avoid watching while eating (snacks or meals). REMINDER: Touch screen technology does NOT count as ‘active’ screen time. Also, watch the quality of children’s movement with active video games

44. Why Support Breast Feeding?

47. Breast Feeding (1) • Breast milk helps to: • Prevent obesity • Defend against infections (keeping infants from getting sick with things like diarrhea and ear infections) • Protect against a number of conditions — like asthma, diabetes, and sudden infant death syndrome (SIDS)

48. In-Depth Review of Physical Activity Goal

49. My Bonnie Lies Over the Ocean My Bonnie lies over the ocean,my Bonnie lies over the sea,My Bonnie lies over the ocean, O bring back my Bonnie to me. Bring back, bring back, O bring back my Bonnie to me, to me.Bring back, bring back, O bring back my Bonnie to me.

50. Knowledge Check • What is the recommended amount of physical activity for toddlers in full day care? • 15 - 30 min • 30 - 45 min • 60 - 90 min • 90 - 120 min