The Downfall of a Girl’s Diet

1. The Downfall of a Girl’s Diet Dr Bob Murray Nationwide Children’s Hospital

2. Childhood Obesity Now

3. % Children Consuming Daily Recommended Intake Children are Overweight and Undernourished Critical Age Iron Phosphorus Zinc Vitamin C Vitamin A Magnesium Folate Calcium Data compiled by Dr. John Lasekan, Ross Labs from NHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998 Data compiled by Dr. John Lasekan, Ross Labs from NHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998 NHANES, CFSII data compiled by Dr. John Lasekan, Ross Labs

4. Males Vit A, Vit C, Vit E Magnesium, potassium Fiber Calcium Females Vit A, Vit C, Vit E Magnesium, potassium Vit B-6 Folate Thiamin Iron Phosphorous Zinc Fiber Calcium Missing NutrientsHigh School Students Clark, Fox, JADA 2009; s44

5. Food intake is based on dailyactivity Meals and snacks Vegetables Fruits whole grains Low-fat milk and dairy Quality proteins To make every calorie count, choose nutrient rich foods The U.S. Dietary Guidelines

6. Activity = Calories a

7. What are the Right Amounts? • 9 year old with moderate activity • 1400 - 1600 calories • Breakfast 400 calories • Lunch 400 calories • Dinner 500 calories • Snack 200 calories 1500 calories

8. Naturally Nutrient Rich the basics of nutrition

9. Naturally Nutrient Rich US Dietary Guidelines Current Children’s Diet Focus on fruits. Vary your veggies. Get calcium-rich foods. Make half your grains whole. Go lean with protein. Know the limits on fats, salt, and sugars.

10. Kids & Snack Foods Snack foods and drinks = 1/3 of daily calories 2/3 of this comes from added sugar ½ of the sugar comes from sweet drinks Which account for 10% of daily calories NHANES III, Kant Arch Ped Adol Med 2003; 157:789

11. Nutr Action Letter, June 2006

12. BEVERAGE CONSUMPTION per person gallons Source: USDA, NMPF

13. Milk’s Nutrients Calcium (30% DV*) Potassium (11% DV) Phosphorus (20% DV) Protein (16% DV) Vitamin A (10% DV) Vitamin D (25% DV) Vitamin B12 (13% DV) Riboflavin (24% DV) Niacin (10% DV)

14. Calcium and Bone

15. MyPyramid: Dairy products 3-a-Day = cups of fat-free or low-fat milk or dairy 2 to 8 years old 2 cups per day 9 to 18 years old 3 cups per day • 8 oz. milk • 1 cup yogurt • 1½ oz. natural cheese • 2 oz. processed cheese

16. Bone Grows Most in Teens Bone Thickness 2 6 10 20 years 1 m 2 y 18 y

17. Kids Don’t Get EnoughCalcium BUT Age Male Female 6-11 y 44% 58% 12-19 y 64% 87% >20 y 55% 78%

18. Too Many Children Avoid Dairy • Low daily calcium • Take in only 400 mg • Need 1300 mg • Reasons given • Feel bad taste lifestyle • More broken bones Black et al, Am J Clin Nutr 2002; 76:675

19. snack foods & drinks

20. More Snacks, More Calories Total MALES FEMALES 0 Snacks 11% 2156 kcal 1501 kcal 1 Snack 25% 2391 kcal 1812 kcal 2 Snacks 26% 2505 kcal 1944 kcal 3 Snacks 19% 2916 kcal 2136 kcal 4 Snacks 18% 3249 kcal 2437 kcal “GRAZING is the new norm” Sebastian, J Adol Health 2008; 42:503

21. Snacks are Low Quality Food FOOD GROUPS SNACKS Grains chips, puffs, breads, cookies Vegetables potato chips, pizza, french fries Fruits OJ, apples, non-citrus juices Milk white, flavored, frozen dairy Meat/beans hot dogs, lunch meats Oils corn chips, puffs, potato chips Solid fats frozen dairy, cookies, milk Added sugars soft drinks, fruit drinks, candies Sebastian, J Adol Health 2008; 42:503

22. “Avoidance” is Not Enough Has created a wrong idea: Few “bad” nutrients = a good food

23. Less fat, fewer calories, but NOT more nutrients Does it deserve this?

24. Read the Whole Label

25. The Baby with the Bathwater?

26. For Smarter Snacking Simple – Fun --FREE Go to www.snackwise.org

27. Emphasize Diet Quality NOT DIETS

28. Limit sweetened beverages Eat 5 servings per day of fruits & vegetables Eat a nutritious breakfast every day Limit portion sizes Have regular family meals Limit screens to a maximum of 2hrs No television in the bedroom Moderate to vigorous physical activity for 60 mins/ day The Most Important Things