Nutrition 101 & managing BMI You will learn... What is BM BMI - PDF document

7/24/17 Nutrition 101 & managing BMI You will learn... • What is BM BMI and why it’s important for RSS/SGA kids • What makes a ba balanced meal • How to ba balance bl blood sugar • 5 important nu nutrient nts/supplement nts • Extra handouts and recipes! 1

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7/24/17 BMI 101 5

7/24/17 What is BMI? • BMI = Body Mass Index • Calculation: – Measure child's we weight (in pounds) – Measure child's he ht (in inches) height – Divide weight by height squared – Multiply that total by 703 Why BMI? • IUGR/SGA children have intrinsic insulin resistance • Rapid weight gain can increase health risks (i.e. Type 2 Diabetes) • Th The goal: to have the least amount of subcutaneous body fat as possible. • Because he height ht is s lo low on growth weight should also be low. chart, we 6

7/24/17 Ideal BMI • RSS/SGA kids: 12 12-14 14 • Co Considerations: – Not one-size-fits-all approach – Varies by muscle mass • More muscle : less fat à higher BMI J • Less muscle : more fat à lower BMI J – SGA kids or RSS mUPD7s may be higher. Example • Child’s weight: 26 pounds • Child’s height: 32 inches Ca Calculation: – Divide weight by height squared (26/32 x 32 = 0.025) – Multiply by 703 (0.025 x 703) – BM 17 (too high) BMI = 17 7

7/24/17 Recommendations • Keep them lean • If you can “pinch an inch” = too much weight • Feed them enough, but not too much • Omit sugar/processed snacks/fried foods • Stick to whole foods • Offer balanced meals How to make BALANCED MEALS 8

7/24/17 The Macronutrients Carbohydrates – Protein - Fat Protein 10-15% of calorie s Why we need it: • Growth, development & energy • Hormones, antibodies, enzymes • Primary source of iron, zinc, B12, etc. What if we don’t get enough: • Stunted growth, diarrhea, lack of appetite 9

7/24/17 Protein Animal Protein Sources Meat (beef, venison) Poultry (chicken) Dairy (cheese, milk) Eggs Fish (salmon, cod) Seafood (shrimp, scallops) Protein Vegetarian Protein Sources Grains & Vegetables Legumes Nuts & Seeds 10

7/24/17 How much protein? 10-15% 0.75 grams of calories per pound In a day… Food Protein Egg (1 large) 6 grams 25 pounds Yogurt (1/2 cup) 4 grams = 18 grams Almond butter (1 tbsp) 4 grams Green peas (1/2 cup) 4 grams TOTAL 18 grams 11

7/24/17 Fat 10-15% of calorie s Why we need it: • Brain = 60% fat! • Carries vitamins A,D,E & K • Improve absorption of nutrients What if we don’t get enough: • Hair, skin, nails disorders (eczema) • Slow growth, depression, slow learning Fat Sources Avocado Olive oil, Coconut oil, Flax Coconut (milk, oil, shredded) Nuts/seeds butters (cashew, pumpkin, hemp) Yogurt & cheese (sheep, goat, buffalo, cow) Fish Eggs Grass-fed meats 12

7/24/17 How much fat? 47% 6% 4-18 18 years 1-3 3 years 25-35% 30-40% of calories of calories Health Canada Don’t fear fat • We all need fat • Good fats do not make us fat • LOW fat = HIGH sugar/salt 13

7/24/17 SUGAR: SUGAR: 12 grams 28 grams Did you know? The risk of ME Th MERC RCURY RY is is OU OUTWEIGHED by by the be benefits of consuming fish www.daniellebinns.com/blog 14

7/24/17 www.ewg.com Carbohydrates Why we need it: • Growth, health, energy, etc. What if we don’t get enough: • Lack of energy • Mineral imbalance • Breakdown of proteins 15

7/24/17 Carb Sources Vegetables Fruit Grains (rice, pasta, quinoa, bread, etc.) Legumes (beans, peas) 16

7/24/17 How much carbohydrate? <5% 45-65% of calories Health Canada Carb 101 Fiber Sugar Starch 17

7/24/17 Fiber: Why it’s important? • Optimal digestion • Promotes cardiovascular health • Supports stabilization of blood sugar How much do we need? 0 0 – 1 1 year ar : n/a 1 1 – 3 3 years : 19 grams 4 4 – 8 8 years : 25 grams 9 9 – 13 13 year ars : 26 grams (F); 31 grams (M) BUT only getting 15 15 gram ams per day 18

7/24/17 In a day… Food Fiber (approx.) Pear (medium) 6 grams Flax (1 Tbsp) 3 grams GOAL GO Banana (medium) 3 grams Oats (1/4 cup) 2 grams 19-25 grams Whole grain pasta (1/2 cup) 3 grams Lentils (1/4 cup) 4 grams Green peas (1/4 cup) 3 grams TOTAL 24 grams Juice vs. Smoothie? SM SMOOTHIES re retain all the FI FIBER. . Be Better for blood sugar balancing. 19

7/24/17 To peel or not? Ch Choose WH WHOLE to to get t th the most t fiber. 1 whole apple, with peel 3.7 grams of fiber 1 whole apple, without peel 2.4 grams of fiber 1/2 cup apple sauce 1.5 grams of fiber 3/4 cup apple juice 0 grams of fiber Sources of Fiber • Lentils, cooked – ½ cup – 7.8g • Oats – ½ cup = 8.3g • Quinoa, cooked – ½ cup = 2.6g • Spinach, cooked – 1 cup = 7g • Raspberries – ½ cup = 4.0g • Whole grain foods 20

7/24/17 Whole grain Whole Grain Examples • Amaranth • Millet • Quinoa • Buckwheat • Rye • Teff • Rice (wild, brown, coloured) • Barley • Oats (whole) • Wheat (spelt, kamut, farro, bulgur) 21

7/24/17 So what makes a BALANCED MEAL? Protein + Fat + Fiber (Carbs) Protein Fat 15% 35% THE PLATE Carbs 50% (Fiber) 22

7/24/17 How to balance BLOOD SUGAR 23

7/24/17 Blood sugar 101 • Blood sugar = blood glucose – In our blood = 1.5 tsp – Coke = 10 tsp • Too much blood sugar: – Damage tissues (diabetes) – Sugar = stored as fat – Insulin resistance Glycemic Load vs. Glycemic Index Go Goal: eat foods that are low GI + low GL . 24

7/24/17 Fueling the fire • Ca Carbs (S (Sugar + High Gly lycemic Food oods) = paper – quick energy, dies fast • Ca Carbs (Fi Fibre) ) + + Pr Protein + + Fa Fat = big piece of oak – burns hot and long 25

7/24/17 Rollercoaster Sugar = Low immunity • “Consuming 100 grams of carbohydrate in the form of glucose, fructose, sucrose, honey, or orange juice can si significantly reduce the ability of white blood cells s to destroy foreign particles and microorganisms.” • After sugar consumption, a 50 50% % reduction of WBC capacity over 5 hours. 26

7/24/17 Balance blood sugar 1. Limit su sugar 2. Choose low gl glycemic foods 3. Have balanced meals: pr protein + fibe ber + fat (PFF) – Especially at br breakfast – carbs with protein/fat/fiber Offer ca Breakfast Ideas • Oatmeal + seeds or coconut oil • Whole grain toast + nut butter • Sweet potato toast + avocado • Chia pudding • Smoothies (not just fruit!) 27

7/24/17 MICRONUTRIENTS & SUPPLEMENTS 101 1. Vitamin D 28

7/24/17 Why it’s important? • Immunity • Supports bone health • Blood sugar control Are they running low? • Mood changes – feeling blue • Bone aches/breaks/fractures 98 98% • Weakness and fatigue 81 81% % % Deficient 2-8 year old 14-18 year old (girls) (boys/girls) 29

7/24/17 How much do they need? Infants - 400 IU Children - 600 IU Rule of thumb: 1000 IU / 25 pounds Sources of Vitamin D • Salmon (3 oz) – 465 IU • Mackerel (3 oz) – 211 IU • Sardines (3 oz) – 164 IU • Tuna (2 ½ oz) – 82-105 IU • Egg yolk (1 large) – 37 IU 30

7/24/17 2. Essential Fatty Acids 31

7/24/17 What are they? ”Essential”: must be consumed via diet or supplements Omega 3 FAs Omega 6 FAs 32

7/24/17 Why are EFA’s important? • Brain development (pre/postnatal) • Sharpened vision in infants • Improved literacy and intelligence • Improved social behaviours (ADHD) Nutrient Boosters • Consume EFA/omega-3 supplement with other fats • Choose grass-fed meats • Choose free-range eggs 33

7/24/17 How much do they need? 0 0 to to 12 month ths: 500 mg 1 1 to to 3 years: 700 mg 4 to 4 to 8 years: 900 mg Sources of Omega 3 • Wild Salmon • Sardines • Herring • Mackerel • Walnuts • Seeds (flax, sesame, sunflower) 34

7/24/17 3. Calcium 35

7/24/17 Wh Why it’s im important? • Supports mu muscle and nerve function • Supports acid/alkaline balance (pH) • Supports bone health Are they running low? Ar • Delay in child’s growth and development • Bone fractures 81 81% • Weakness and fatigue 23 23% % % Deficient 2-8 year old 14-18 year old (girls) (boys/girls) 36

7/24/17 How much do we need? 0 – 6 months – 200mg 6 – 12 months – 260mg 1 – 3 years – 700mg 4 – 8 years – 1,000mg 9 – 13 years – 1,300mg Dairy Sources of Calcium • Milk (1 cup) - ~300 mg • Yogurt (3/4 cup) – ~300 mg • Cheese (1.5 oz) - ~400 mg • Kefir (3/4 cup) – 187 mg • Cottage cheese (1 cup) – 145 mg NO NOTE : Calcium blocks iron absorption 37

7/24/17 Dairy-free So Sources • Chia seeds (2 oz) – 358 mg • Sesame seeds (1/4 cup) – 351 mg • Spinach (1 cup) – 245 mg • Blackstrap Molasses (1 Tbsp) – 172 mg • Salmon canned (1/2 cup) – 232 mg 4. Iron 38

7/24/17 Why it’s important? • Stores decline ~6 months • 1 1 in 8 toddlers anemic <2 years old • Cognitive, motor, and behavioral benefits • Supports appetite Are they running low? • Bl Blue-ti tinged or pa pale wh whites of ey eyes es • Blood in stool • Brittle nails • De Decreased ap appetite (especially in children) • Fatigue/Irritability • Pale skin • Un Unusual fo food cravings (p (pica) 39