Nutrition presentation for preschool parents

1. Bonnie Y. Modugno, MS, RD
www.muchmorethanfood.com
Let’s Eat
Strategies for Feeding Healthy Families

2. Agenda
1. Food as a developmental tool
2. Food as nourishment
3. Feeding healthy families
a. Strategies at home
b. Strategies away from home
4. Special concerns
a. Picky eaters
b. Food allergies
c. Specific dietary concerns

3. Food as a developmental tool
• Breastfeeding vs. bottle feeding
–
–
–
–
Taste preferences
Muscular development
Microbiome
Self regulation

4. Food as a developmental tool
• Introduction of solid foods
–
–
–
–
–
Taste preferences
Muscular development
Microbiome
Self regulation
Metabolic impact

5. Which complementary foods first?
• Solid foods or supplemental foods
were not routinely offered to babies
less than one year of age before
1920.

6. Survey of Pediatricians
• What do you recommend for baby’s first food?
White Rice
Whole Grain
A vegetable
A fruit
Egg Yolk
Meat
Other
% of respondents
0
10
20
30
40
Medscape Pediatrics Commentary: Starting Solid Foods: Are We Doing It Right? July 6, 2011/ 2012

7. Infant Cereal
Nutrition Facts
Serv. Size 1/4 cup (16g)
Amount Per Serving
Servings Per Container 14
Calories
60
Total Fat:
0.5g
Trans Fat:
0g
Sodium:
0mg
Potassium:
15mg
Total Carbohydrates:
13g
Dietary Fiber:
0g
Sugar:
1g
Protein:
1g
• Ingredients
RICE FLOUR, TRI- AND DICALCIUM
PHOSPHATE, SOYBEAN OIL, SOY
LECITHIN, MIXED TOCOPHEROLS (TO
PRESERVE
FRESHNESS), ELECTROLYTIC
IRON, ZINC SULFATE, ALPHA
TOCOPHERYL ACETATE (VITAMIN E)
NIACINAMIDE (A B
VITAMIN), PYRIDOXINE
HYDROCHLORIDE (VITAMIN
B6), RIBOFLAVIN (VITAMIN
B2), THIAMIN MONONITRATE (VITAMIN
B1), FOLIC ACID (A B
VITAMIN), VITAMIN B12
(CYANOCOBALAMIN)

8. The spectrum of baby foods

9. Considering first foods
Infant food
GI
GL
Rice cereal (US)
95 6
Sweet potato (Australia)
66 17
Oat porridge (Sweden)
55 15
Taro (Pacific Islanders)
55 4
Hominy (Pima Indian)
40 12
Casava (Kenya)
46 12
Lentils (India)
29 5
Pinto beans (Mexico)
14 4
Fermented Maize (Ghana)
12 7
Hummus (Turkey)
6
0

10. Unconventional first foods
Rethinking First Foods
Avocado
Pureed meat based gruels, soups
Pureed chicken, beef, pork, lamb
Mashed, pureed fish
Eggs, egg yolk
Yogurt, Greek yogurt
Tofu
Mashed, beans, lentils
Mashed cooked vegetables

11. Smart Bites for Baby
• Recipes with insight
– Developmentally
appropriate
– Nutritionally on target

12. Food as a developmental tool
• The growing child
–
–
–
–
–
Taste preferences
Metabolic impact
Microbiome
Self regulation
Metabolic impact
• Regardless of body size

13. What Toddlers Eat
70
60
50
40
30
20
10
0
6-8.9 mo
9-11.9 mo
12-14.9 mo
15-17.9 mo
18-24 mo
Feeding Infants and Toddlers Study (FITS) ADAJ 2010

14. Consumption patterns of infants and toddlers
consuming foods at least once a day
70
60
50
40
30
20
10
0
Feeding Infants and Toddlers Study (FITS) ADAJ 2010
6-8.9 mo
9-11.9 mo
12-14.9 mo
15-17.9 mo
18-24 mo

15. Feeding Children
Choosing more whole foods
FOOD
GI
GI
Scone
92
Cooked peas
48
Pretzels
83
Chicken nuggets (Aust)
44
Waffle
76
Pasta (al dente)
43
Vanilla wafers
77
Banana (slightly under ripe) 42
French fries
75
Apple
40
Cheerios cereal
74
Pinto beans
39
Graham crackers
74
Fish fingers
38
Bagel
72
Yam
37
Oatmeal
69
Pear
33
Arrowroot biscuit
63
Yogurt – (Aust/sweetened)
27

16. Choosing meals: balance is key
• Question the role of
“kid’s food”
• Question the premise
of being able to eat
“whatever you want”
• Question the thinking
behind “getting away
with it”

17. Feeding Healthy Families
• At home
• Away from home

18. What to look for
•
•
•
•
Choices
Variety of mostly whole foods
Balanced meal options
Appropriate portions

19. Kid’s Meals
SIT DOWN RESTAURANTS
N=12
10
8
Only 4 out of 61 menu
options included a
fruit or vegetable
(less than 7%)
Pizza
Burger/Fr
Dog/ Fr
6
Mac'nCh
4
Pasta
2
Sand/Fr
0
Chx/Fr
PRO/Veg
Modugno, MS, RD. Survey 2005. Unpublished

20. Choices for parents…
and their kids

21. Fast food and child obesity
• Fact vs. fiction
– Sloppy assumptions
promoted in popular
press, public health, &
medical venues
– Background diet more
significant than fast food
meals
Poti, et al. The association of fast food consumption with poor dietary
outcomes and obesity among children: is it the fast food or the remainder
of the diet? AJCN Oct, 2013.

22. Challenging Conditions
• Picky eater
• Food allergies
• Specific dietary concerns

23. Introducing New Foods
• What is the average
number of tries before
success?

24. Introducing New Foods
Average number of
tries before success?
• 14-16 times
• Most care givers give up
after three attempts

25. NEOPHOBIA
Parents
Siblings
Anxiety
Emotionality
Genetic Traits
•Exposure
•Modeling
Behavioral
Factors
Environmental
Factors
•In utero
•Breastfeeding
British Journal of Nutrition (2008), 99, Suppl. 1, S15–S21

26. Picky eater or something else?
•
•
•
•
•
•
Texture
Temperature
Mouth feel
Taste
Smell
Color

27. Pediatric Food Allergies in US
Amy M. Branum and Susan L. Lukacs , Pedriatrics. Food Allergy Among
Children in the United States. Nov 16, 2009 DOI: 10.1542/peds.2009-1210

28. Food Allergies
• Possible Contributing Factors
– Poor diet increases inflammation
• Omega 6: omega 3 imbalance
• Excess sugar, refined starch
– Compromised gut microbiome
– ??? Hygiene hypothesis, pesticides, genetic
engineering, less diverse food supply

29. The case with
gluten
MSG
Smoke flavors
Glazes
Textured vegetable protein
Artificial flavors
Ice cream, frozen yogurt
Hydrolyzed vegetable
protein
Natural colors
Instant teas, coffees
Hydrogenated starch
hydrozylate
Artificial colors
Mayonnaise
Hydroxypropylated starch
Caramel coloring &
flavoring
Mustard
Pregelatinized starch
Soy sauce
Frying oil
Vegetable gum
Miso
Seasoned poultry/meat
Vegetable protein
Boullion or stock cubes
Sour cream
Extenders and binders
Cheese foods/spreads
Dry & honey roasted nuts
Maltodextrin
Dextrin
Maltose
Baking powder
Natural flavors
Chocolate

30. Special Diets
•
•
•
•
•
Autism, ADHD
Diabetes
Seizures, epilepsy
Overweight/obesity
Disordered eating/eating disorders

31. Feeding Healthy
Families
Supporting better metabolic health for children
 Support breastfeeding
 Provide nutrition & other
meaningful support for
mom post partum
 Prepare first foods from
whole foods
 Exercise caution re:
commercial baby foods
 Encourage balance for all
meals and
snacks, especially for
those children w/ higher
metabolic risk

32. Thank You!
Q&A
Bonnie Y. Modugno, MS, RD
www.muchmorethanfood.com
Let’s Eat
Strategies for Feeding Healthy Families