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Childhood Obesity Part 3

Provided Courtesy of RD411.com Where dietitians go for information. Childhood Obesity Part 3. Adapted with permission of Lucille Beseler, MS, RD, LD. Review Date 1/08 K-0527. Food groups: Fruits and vegetables Grains Milk and dairy Protein Other. Color code:

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Childhood Obesity Part 3

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  1. Provided Courtesy of RD411.com Where dietitians go for information Childhood Obesity Part 3 Adapted with permission of Lucille Beseler, MS, RD, LD Review Date 1/08 K-0527

  2. Food groups: Fruits and vegetables Grains Milk and dairy Protein Other Color code: Green foods—foods containing <20 calories/ serving Yellow foods—major diet stables Red foods—high in fat and simple carbohydrate Nutrition Treatment: What Works?Traffic Light Diet

  3. Nutrition Treatment: What Works?Traffic Light Diet • Calorie intake is controlled and determined—average 900-1200 calories • Families are provided with food reference guide, listing foods, color code, and food group • Family goals—stay within prescribed calorie range and eat no more than five red foods/week • Other components include self-monitoring, behavior modification, and contracting

  4. Nutrition Treatment: What Works?Traffic Light Diet • Use of the Traffic Light Diet, as part of a multicomponent weight-loss treatment program: • Associated with short- and long-term weight loss in 6-12 year olds Source: Epstein LH, Paluch RA, Gordy CC, Saelens BE, Ernst MM. Problem solving in the treatment of childhood obesity. J Consult Clin Psychol. 2000;68:717-721.

  5. Nutrition Treatment: What Works?Low-Glycemic Load Diet • High-glycemic index foods produce a large increase in postprandial blood glucose and play a role in appetite regulation • In adults, a high-glycemic index diet is linked to central adiposity • Studies suggest that children on a low-glycemic diet are less hungry, which results in the consumption of fewer calories

  6. Nutrition Treatment: What Works?Low-Glycemic Load Diet • Use of a low-glycemic diet is effective for: • Modest weight loss in adolescents • Possibly for long-term weight loss in adolescents Source: Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced-glycemic load diet in treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003;157:773-779.

  7. Nutrition Treatment: What Works? Low-Glycemic Load Diet Glycemic Index of Foods • Low-GI foods: <55 • Medium-GI foods: 55-70 • High-GI Foods: 70

  8. Nutrition Treatment: What Works? Protein-Modified Fast Diet • There is insufficient evidence to suggest that high-protein, low-carbohydrate, very low-calorie diets result in greater long-term weight loss in children, as compared to a balanced macronutrient diet

  9. Nutrition Treatment: What Works? Pharmacological and surgical treatments • Sibutramine and orlistat studies: • Both produce modest weight loss in adults at approximately 3%-8% • Drug therapy does not address lifestyle, physical activity, and behavioral changes, which are all necessary to produce healthy weight loss • Bariatric surgery—the last resort for severely obese adolescents Source: Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002;360:473-482.

  10. Nutrition Treatment: What Works? All interventions culturally adapted • Understand cultural beliefs • Adopt culturally acceptable and appropriate words to teach Sources: The American Dietetic Association. Diversity Resource List—Food Guide Pyramids. Available at: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/ CADE_3868_ENU_HTML.htm. Accessed December 12, 2007. Stein K. Cultural literacy in health care. J Am Diet Assoc. 2004;104:1657-1659. Kraft Foods. Healthy living tools. Available at: http://www.kraftfoods.com/kf/ HealthyLiving. Accessed December 13, 2007.

  11. Advising Parents:Easy Tips on What to Do • Provide healthy foods • Encourage breakfast • Review lunch menus with day care/ preschool or caretakers • Eat meals as a family • Get kids to help in the kitchen • Even young children can help with simple tasks • Strive for appropriate portions for the entire family

  12. Advising Parents: Easy Tips on What to Do What’s safe in growing children? • Give eating specifics if necessary • Cut back on fat—visible fat and invisible fat • Cut back on sugar—especially from juice and snacks (offer water instead of juice or soda and healthy snacks) • Encourage whole grains, such as brown rice, wheat pasta, whole-wheat bread, and whole- grain cereals

  13. Advising Parents: Easy Tips on What to Do • Recommend that the family cut back on fast food to 1 time/week • Help family establish eating-out rules • Provide amount and calorie parameter for daily snacks • 100-calorie snacks • Eat five fruits and vegetables/day • Encourage nutrient-dense beverages, such as milk • BMI >85th percentile change to lower-fat milk • Eat lean meat, poultry, low-fat cheese, and fish

  14. Advising Parents: Easy Tips on What to Do Environment • Structured eating in approved places • Not in the car—no dashboard dining • Not in their rooms alone • Eat family meals • Prevent grazing throughout day • Rules for snacks (asking permission or providing an allowable snack box)

  15. Teach Parents to Become Advocates • Fast-food companies offer lunches in many day care centers/preschools • Fast-food lunch for a toddler can provide 50% of the day’s calories • Busy parents often opt for their toddlers to eat the center’s lunch • Day-care centers/preschools often have many snacks and unlimited juice • Day-care centers/preschools should incorporate standard practice of feeding • Empower parents as nutrition advocates for their children Source: Fox MK, Pac S, Devaney B, Jankowski. Feeding infants and toddlers study: what foods are infants and toddlers eating? J Am Diet Assoc. 2004;104(suppl 1):s22-s29.

  16. Prevention

  17. Childhood Obesity Prevention is easier than treatment Health care professionals should: • Teach good nutrition to families and children right from the start • Take advantage of the many teachable moments for parents during their child’s first year of life, stressing the importance of nutrition • Review growth charts with parents at each visit • Offer nutrition tips at each visit

  18. 10 worst foods for kids Prepackaged lunches Instant-flavored noodles Hot dogs Fruit leather Toaster pastry Cereal with candy Candy (sticky or hard) Doughnuts/snack cakes Soda pop/fruit-flavored drinks Coffee/tea 11 best food for kids Yogurt Sweet potatoes Broccoli Wheat bread/whole-grain cereal Beans Milk Cantaloupe Bananas Eggs Tomatoes Fish Worst and Best Foods for Kids Sources: Bazarte M, Beseler L. Nurturing With Nutrition. Gulfstream, FL: DMI Publications, 2001. Family Nutrition Center. Available at: www.nutritionandfamily.com. Accessed December 13, 2007.

  19. Treatment for Childhood Obesity • Help make childhood obesity a national health priority: • Through parent education—prevention is the best cure • By taking a leadership role in this initiative

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