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Creating Positive Health Outcomes for Children by Improving Their Nutritional Environment in Schools. Mari Richardson, MPH Student Walden University PUBH 6165-3 Instructor: Robert Marino Winter Quarter, 2011. Learning Outcomes. Describe the effects of poor nutrition
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Creating Positive Health Outcomes for Children by Improving Their Nutritional Environment in Schools Mari Richardson, MPH Student Walden University PUBH 6165-3 Instructor: Robert Marino Winter Quarter, 2011
Learning Outcomes • Describe the effects of poor nutrition • Define healthy eating and quality nutrition • Recognize the need for change in the school nutrition environment • Discover ways to improve school based nutrition • Develop a school health program that promotes healthy eating • Implement policies and standards for better school nutrition
What is Poor Nutrition? • Too many or not enough calories • Improper balance of carbohydrates, protein, and fat • Not enough fiber • Not enough minerals (e.g. calcium) • Lack of the proper amount of vitamins in our diet (e.g. vitamins A, B, C, D, E, and K) The Columbia Electronic Encyclopedia. (2007). Columbia University Press. Retrieved from http://encyclopedia2.thefreedictionary.com/nutrition
Effects of Poor Nutrition on Children • Undernourishment • Overweight/Obesity • Anemia • Dental Caries • Chronic Diseases World Health Organization [WHO]. (2007). Integrating poverty and gender into health programs: a sourcebook for health professionals. Retrieved from http://www.wpro.who.int/NR/rdonlyres/8856985D-6646-4C98-AF5D-B7DDF43CEA06/0/Nutritionmodule2.pdf
Undernourished Children • Have problems learning • Have trouble recovering from infections and injuries • Experience poor growth • Have behavioral problems • Have low energy Nemours. (2011). Kids health: hunger and malnutrition. Retrieved from http://kidshealth.org/parent/growth/feeding/hunger.html
Overweight/Obesity • Caloric imbalance • Prevalence = 19.6% in ages 6-11, 18.1% in adolescents 12-19 • Associated with high cholesterol, hypertension, respiratory disorders, and diabetes in children • Causes psychological stress Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. (2008). Prevalence of high body mass index in US children and adolescents. JAMA 2010;303(3):242–9. U.S. Surgeon General. (2007). Overweight and Obesity: Health Consequences. Retrieved from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm
Iron Deficient Anemia • Prevalence = 2% of children age 6-11, 6% of adolescents age 12-19. • Anemia causes: • Fatigue • Reduced resistance to infection • Low attention span • Impairs learning Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. (1997). Prevalence of iron deficiency in the United States. JAMA ;277:973--6.
Dental Caries • Linked to sugar consumption • Affects 52% of children ages 6-8 and 67% of 12-17 year olds. • Annual school time lost = 50 million hours • Causes infection, pain, and tooth loss American Academy of Pediatrics. (2010). Overview of dental caries. Retrieved from http://www.aap.org/oralhealth/cme/page4.htm
Chronic Diseases • Coronary Heart Disease • Cancer • Stroke • Osteoporosis U.S. Surgeon General. (2007). Overweight and Obesity: Health Consequences. Retrieved from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm Centers for Disease Control and Prevention [CDC]. (1999). Effects of childhood eating patterns on chronic disease risks of adults Retrieved from http://www.cdc.gov/mmwr
Healthy Eating and Quality Nutrition • Carbohydrates • Protein • Fats • Vitamins • Minerals • Fiber U.S. Department of Agriculture. (2010). My pyramid.gov: tips and resources. http://www.mypyramid.gov/tips_resources/index.html.
Daily Caloric Proportions Ages 4-8 • Girls =1200-1800; Boys =1400-2000 Ages 9-13 • Girls =1600 -2200; Boys =1800-2600 Ages 14-18 • Girls =1800 -2400; Boys =2200-3200 U.S. Department of Agriculture. (2005). Dietary guidelines for Americans. Retrieved from http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2005/2005DGPolicyDocument.pdf
Daily Macronutrient Proportions • Protein = 10% - 30% of caloric intake • Carbohydrates = 45% - 65% of caloric intake • Fats = 25% - 35% of caloric intake • Fiber = 14 grams per 1,000 calories for children U.S. Department of Agriculture. (2005). Dietary guidelines for Americans. Retrieved from http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2005/2005DGPolicyDocument.pdf
Physical Activity • Children and teenagers need at least 60 minutes every day • Aerobic Activity • Muscle Strengthening • Bone Strengthening Centers for Disease Control and Prevention. (2010). How much physical activity do children need? Retrieved from http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html
Need For Change In Duval County Public Schools • 70% = failed President’s physical fitness test • 27.9% and 28.4% = overweight Duval county middle and high school students • 49 = where we ranked last year in childhood obesity Duval County Health Department. (2009). Healthy kids, healthy Jacksonville: a community call to action to reduce childhood obesity. Retrieved from http://www.dchd.net/files/DCHC_ActionPlanRev.pdf
Ways to Improve School Nutrition • Healthier options in vending machines • Education on health, nutrition, physical activity, BMI, and safe weight loss • Healthy and well balanced meal options in the cafeteria • Increased opportunities for physical activity in the classroom Centers for Disease Control and Prevention [CDC]. (2004). The role of schools in preventing childhood obesity. Retrieved from http://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf
How to Develop a Program That Promotes Healthy Eating • Get parents involved • Survey students and get them excited • Review nutrition and physical activity curricula • Interview nutrition professionals Centers for Disease Control and Prevention [CDC]. (2003). Building a healthier future through school health programs. Retrieved from http://www.cdc.gov/HealthyYouth/publications/pdf/PP-Ch9.pdf
Implement Policies and Standards • Requirements for physical activity • Standards for foods and beverages offered in schools • Comprehensive nutrition education • Coordinate school food service with nutrition education Centers for Disease Control and Prevention [CDC]. (2007). School based obesity prevention strategies for policymakers. Retrieved from http://www.cdc.gov/HealthyYouth/policy/pdf/obesity_prevention_strategies.pdf
Conclusion • Poor nutrition = imbalance in carbohydrates, fat, protein, fiber, vitamins, and minerals • Effects of poor nutrition = undernourishment, obesity, anemia, dental caries, and chronic diseases • Quality nutrition = proper caloric, macro, and micro proportions • Ways to improve school nutrition = provide healthier options in cafeteria and vending machines, in depth education on nutrition to students, and increase opportunities for exercise • How to develop a program = get parents and students involved, review current curricula, and interview nutrition professionals • Implement policies and standards for physical activity, foods offered at school, and nutrition education
References • American Academy of Pediatrics. (2010). Overview of dental caries. Retrieved from http://www.aap.org/oralhealth/cme/page4.htm • Centers for Disease Control and Prevention [CDC]. (1999). Effects of childhood eating patterns on chronic disease risks of adults. Retrieved from http://www.cdc.gov/mmwr • Centers for Disease Control and Prevention [CDC]. (2003). Building a healthier future through school health programs. Retrieved from http://www.cdc.gov/HealthyYouth/publications/pdf/PP-Ch9.pdf • Centers for Disease Control and Prevention [CDC]. (2004). The role of schools in preventing childhood obesity. Retrieved from http://www.cdc.gov/HealthyYouth/physicalactivity/pdf/roleofschools_obesity.pdf • Centers for Disease Control and Prevention [CDC]. (2007). School based obesity prevention strategies for policymakers. Retrieved from http://www.cdc.gov/HealthyYouth/policy/pdf/obesity_prevention_strategies.pdf • Centers for Disease Control and Prevention. (2010). How much physical activity do children need? Retrieved from http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html • Duval County Health Department. (2009). Healthy kids, healthy Jacksonville: a community call to action to reduce childhood obesity. Retrieved from http://www.dchd.net/files/DCHC_ActionPlanRev.pdf
References cont… • Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. (1997). Prevalence of iron deficiency in the United States. JAMA ;277:973--6. • Nemours. (2011). Kids health: hunger and malnutrition. Retrieved from http://kidshealth.org/parent/growth/feeding/hunger.html • Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. (2008). Prevalence of high body mass index in US children and adolescents. JAMA 2010;303(3):242–9. • The Columbia Electronic Encyclopedia. (2007). Columbia University Press. Retrieved from http://encyclopedia2.thefreedictionary.com/nutrition • U.S. Department of Agriculture. (2005). Dietary guidelines for Americans. Retrieved from http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2005/2005DGPolicyDocument.pd • U.S. Department of Agriculture. (2010). My pyramid.gov: tips and resources. http://www.mypyramid.gov/tips_resources/index.html • U.S. Surgeon General. (2007). Overweight and Obesity: Health Consequences. Retrieved from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm • World Health Organization [WHO]. (2007). Integrating poverty and gender into health programs: a sourcebook for health professionals. Retrieved from http://www.wpro.who.int/NR/rdonlyres/8856985D-6646-4C98-AF5D-B7DDF43CEA06/0/Nutritionmodule2.pdf
Further Reading • Action for Healthy Kids: www.actionforhealthykids.org • American Dietetic Association: www.eatright.org • Better Health Research: www.betterhealthresearch.com/poor-diet • Centers for Disease Control and Prevention: http://www.cdc.gov/HealthyYouth/obesity/ • Food and Drug Administration: http://www.fda.gov/newsevents/speeches/ucm053648.htm • Healthy Jacksonville: www.healthyjacksonville.com • Mayo Clinic: http://www.mayoclinic.com/health/childhood-obesity/DS00698