Isfahan University of Medical Sciences · 2015. 4. 27. · • Apersonalized eatingplan bas on allthe essential nutrients whilelimiting nutrients associ development. • MyPyramid

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• Feeding school age chil

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ldren&adolescence

•-School-aged children (ages � to ��) continnutritious snacks. They have a consistent bufour to five times a day (including snacks).•Dependent to family than school

•-Many food habits, likes, and dislikes are es

•-Family, friends, and the media (especiallyeating habits.• -School-aged children are often willing to eyounger siblings.• -Eating healthy after-school snacks(sandwsnacks may contribute up to one-third of th

•. -School-aged children have developed moat feeding skills, and are able to help with m

nue to need healthy foods andut slow rate of growth and usually eat

stablished during this time.

TV) influence their food choices and

eat a wider variety of foods than their

wiches…….) are important, as thesehe total calorie intake for the day

ore advanced feeding skills, are bettermeal preparation.

Breakfast is a main mealWake up earlier

Always serve breakfast, even if it has toquick, healthy breakfast include the fo

• fruit• milk• bagel• cheese toast• cereal• peanut butter sandwich

o be "on the run." Some ideas for allowing:

• Take advantage of big appetites asnacks such as the following:

• fruit• vegetables and dip• yogurty g• sandwich• cheese and crackers• milk and cereal

after school by serving healthy

.

• Allow children to help with me

• Serve meals at the table, instetelevision, to avoid distraction

eal planning and preparation.

ead of in front of thens.

• Healthy food choices:

• Chronic disease prophilaxis(diabet

• Carbohydrates ��% ,prot ��% ,fatof cal intake

• limit Sweet,fat Diet

• Icrease demand in ca,riboflavin,ni

• Demand to near to����Kcal/day (• Demand to near to����Kcal/day (

• The food guide my pyramid is a gua healthy diet.

•• The food guide my pyramid can he

foods while encouraging the right

•

tes.m,malignancies,……

t ��%(��%sat,��%un sat,��%bivalent)

cotinic Acid,vit D,…..

��Kcal/kg/day)��Kcal/kg/day)

uideline to help you and your child eat

elp you and your child eat a variety ofamount of calories and fat.

• Most U.S. professional organizarecommend the use of the USDa basis for building an optimal

• MyPyramid is based on the Die

ations and governmental agenciesDA MyPyramid (www.mypyramid.govdiet for children and adolescents

etary Guidelines for Americans.

• A personalized eating plan bason all the essential nutrientswhile limiting nutrients associdevelopment.

• MyPyramid is aimed at the geprevious versions of the food

• The intent is to primarily useinteractive tool that allows cubased on age, sex, physical actweight and height.

• Print material is also availableaccess

sed on these guidelines provide,necessary for health and growth,ated with chronic disease

eneral public and differs frompyramid in many ways.

MyPyramid as an Internetstomization of recommendations,tivity, and, for some populations,

e for families without Internet

• �-Proposed daily food intake• How many cup(oz) or srv for how much

• �-Energy level for proposed• Based on sex,age,activity

• Calculation of EER

• �-Nutritional goal for propo• For each group (AGE,SEX) how mach vit

C,……,FE,CA,ZN,…Carbohydrate,fiber,pro

�-Nutrient profile of food guidsubgroups

Each cup fruit,vegtable,meat,… contain: hca,Mg,….how much cal,carbohydrate,prot

e pattern:h cal

intake pattern:

sed daily food intaket A Eot,fiber.,,...

de pyramid food groupe and

how much vit a,c,tiamin,B�,B��,….how mucht,fiber,fat,,…

Tables:

• The Food Pyramid is dividedrepresenting the � food gro

• Orange represents grains: Make hawhole grains. Whole-grain foods inflour, whole cornmeal, brown rice,the food label on processed foods -grain" should be listed before the s

• Green represents vegetables: VaryGreen represents vegetables: Varyvariety of vegetables, including darkinds, legumes (peas and beans), svegetables.

• Red represents fruits: Focus on frujuice counts as part of the fruit grofrozen, or dried, and may be whole

d into � colored bandsoups plus oils:

alf the grains consumed each daynclude oatmeal, whole-wheat

and whole-wheat bread. Check- the words "whole" or "wholespecific grain in the product.

your vegetables. Choose ayour vegetables. Choose ark green- and orange-coloredtarchy vegetables, and other

its. Any fruit or ��� percent fruitoup. Fruits may be fresh, canned,e, cut-up, or pureed

• Yellow represents oils: Know the limitsMake most of your fat sources from fisfats like butter, stick margarine, shortecontain these.

• Blue represents milk: Get your calciumcontain calcium and vitamin D, both immaintaining bone tissue. Use lowfat orHowever, during the first year of life, infortified formula Whole cow’s milk mafortified formula. Whole cow s milk mabirthday, but lower-fat or skim milk shleast two years old.

• Purple represents meat and beans: Gomeats and poultry. Vary your protein rpeas, and beans

s on fats, sugars, and salt (sodium).sh, nuts, and vegetable oils. Limit solidening, and lard, as well as foods that

m-rich foods. Milk and milk productsmportant ingredients in building andr fat-free milk after the age of two years.nfants should be fed breast milk or iron-ay be introduced after an infant’s firstay be introduced after an infant s firstould not be used until the child is at

o lean on protein. Choose low fat or leanroutine - choose more fish, nuts, seeds,

• It should be noted that a diet basprovide all the necessary nutrient

• MyPyramid also provides informawhich are the foods that are notguidelines because of their low nsweetened beverages, sweetenedmeats.

• It allows a very small amount of dh deach day.

The vast majority of children anddiet that follows the recommend

• In general, intake of discretionarrecommended, with frequent conbeverages (soda, juice drinks, icehigh-fat meat (bacon, sausage), a(cheese, ice cream).

sed on MyPyramid, in order tots

ation on discretionary calories,included in MyPyramidutritional value, such asd bakery products, or higher-fat

discretionary calories available

adolescents do not consume aations of MyPyramid.

y calories is much higher thannsumption of sweetenedd tea, sport drinks), snack foods,

and high-fat dairy products

• Intake of dark green and orangwhite potatoes), whole fruits, rewhole grain is typically lower th

• Furthermore, unhealthful eatinrecommended portion sizes; foor salt

• skipping breakfast and/or lunch

• fad diets—is prevalent and ass

• Therefore, MyPyramid offers ato assist pediatrician counselingfor short- and long-term health

ge vegetables (as opposed to friededuced-fat dairy products, and

han recommended.

ng habits—such as larger-than-od preparation that adds fat, sugar,

h

ociated with a poorer diet quality.

helpful and customer-friendly toolg families on optimal eating plans.

• Activity is also represented on the pclimbing them, as a reminder of

act

• According to the Dietary Guidelinesenergy intake of �� to ��� calories pexcess fat can reduce the rate at whreduction in energy intake, they wilage. Help your child to find higher-chis/her daily intake

pyramid by the steps and the personf the importance of daily physicalivity

s for Americans ����, a decrease inper day for children who are gaininghich they gain weight. With thisl grow into a healthy weight as they

calorie foods that can be cut from

• Nutrition and activity tips• Try to control when and where food is eate

daily meal times with social interaction andbehaviors.

• Involve children in the selection and prepahealthy choices by providing opportunitiesnutritional value.

• For children in general, reported dietary into be of concern by the USDAto be o co ce by t e US

• : vitamin E, calcium, magnesium, potassiumnutrients when possible.

• Most Americans need to reduce the amoucomes to weight control, calories do countnon-processed foods helps limit calorie int

en by your children by providing regulard demonstration of healthy eating

ration of foods and teach them to makes to select foods based on their

takes of the following are low enough

m, and fiber. Select foods with these

nt of calories they consume. When itt. Controlling portion sizes and eatingtake and increase nutrients

• Parents are encouraged to provide rec

• Parents are encouraged to limit childrcomputer use to less than two hours dwith activities that require more move

• Children and adolescents need at leasphysical activity on most days for mainphysical activity on most days for mainfor healthy weight during growth.

• To prevent dehydration, encourage chphysical activity and drink several glasphysical activity is completed.

commended serving sizes for children.

en’s video, television watching, anddaily and replace the sedentary activitiesement.

st �� minutes of moderate to vigorousntenance of good health and fitness andntenance of good health and fitness and

hildren to drink fluid regularly duringsses of water or other fluid after the

At home, much of what children andtheir parents.

Typically, parents shop for groceries afood is available in the house

It has been demonstrated that modelIt has been demonstrated that modelparents is a critical determinant of thadolescents .

Therefore, pediatric counseling to imparents in using their influence to maand attractive at home.

adolescents eat is under the control o

and they control, to some extent, wha

ling of healthful eating behavior byling of healthful eating behavior bye food choices of children and

mprove diet should include guidingake healthier food choices available

Regular family meals sitting at a table,the living room, or watching televisionmproved diet quality, perhaps becaus

positive parenting during meals.

Such an ideal situation is recommendfamilies who, with busy schedules andprovide such a setting.

Pediatricians should work with familiethese eating issues.

, as opposed to eating alone, inn, have been associated withse of increased opportunities for

ded but a challenge for manyd other stressors, are unable to

es to set realistic goals around

Another parenting challenge is to conhildren and adolescents

seful strategies, when the child is still�-min pause before a �nd servin

ff i f d th t i ffi i tlor offering foods that are insufficientlwhole grains, or fruits.

trol the excess appetite of some

hungry after a meal, include a ��- to

l d h t blly consumed, such as vegetables,

Eating at School

. children take � or � meals a day in sshould therefore keep themselves infpolicies and menus in their districts astandards.

Where the quality of school nutritionWhere the quality of school nutritionalternative is to suggest that children

chool. Pediatricians and parentsformed of the school's nutritionand advocate for improved

n is problematic a practicaln is problematic, a practicaln pack their own lunch from home.

• Eating Out

• The number of meals eaten outsfrom take-out restaurants has incpopulation.

• The increased convenience of thby the generally lower nutritionato home-cooked meal

ide the home or brought homecreased in all age groups

his meal pattern is underminedal value of the meals, compared

• Typically, meals consumed or pcasual restaurants are of largecalories, and contain large amofats, salt, and sugar and low amand vegetables.

• Although an increasing numbealternatives the vast majority oalternatives, the vast majority orestaurants does not fit MyPyra

• Parents can use these opportuhealthful choices within the ch

purchased in fast-food orportion size, are dense in

ounts of saturated and transmounts of whole grains, fruits,

er of restaurants offer healthierof what is consumed atof what is consumed atamid.

unities to teach and modeloices offered.

• an increasing number of meals anduring peer social gatherings at fr

• .

• When a large part of a child's or aon these occasions, the diet qualofferings are typically of low nutr

•• Parents and pediatricians need to

these occasions while maintaininmeaningful social interactions

• .

• These occasions often are also oconsume alcohol; therefore, adul

nd snacks are also consumedriends’ houses and parties

adolescent's diet is consumedity can suffer, because food

ritional value.

o guide d teens in navigatingg a healthful diet and enjoying

pportunities for teens tot supervision is important

• Most families intend to providediet

• The discrepancy between this fadiet consumed by children is oftebarriers for families to make hea

• Because the final food choice is mtheir parents, interventions to imi di id l dk l d b h iindividual ndknowledge a behavilimited success.

• One of the main determinants ofactors also influence these choic

their children with a healthful

act and the actual quality of theen explained by difficulties andlthful food choicesmade by individual children or

mprove diet have focused oni h b t th h h dior changes, but these have had

of food choice is taste, but otherces.

• . One of the most useful conceptchild's food environment in the cvariety and levels of the determiphysical activity choices.

• Many of these determinants areindividual children or parentsindividual children or parents

• Understanding the context of foounderstanding lack of changes odecrease the frustration often exwho might “blame the victim” founder their control.

tual frameworks to understand thecontext of obesity illustrates theinants of individual food and

e not under the direct control of

od and lifestyle choices helps inr “poor compliance” and canxperienced by the pediatriciansor behavior that is not entirely

• Marketing and advertising of foillustrative aspect of the food en

• Television advertising is an impoadolescents hear about food

• Additional food advertisementplacement in movies and TV shogames.games.

od to children is a particularlynvironment

ortant part of how children and

increasingly occurs as brandows, on websites, and even video