Optimal Nutrition At First Bite: Identifying First Foods For - - PowerPoint PPT Presentation

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Optimal Nutrition At First Bite: Identifying First Foods For - - PowerPoint PPT Presentation

Feb 11, 2023 134 likes •789 views

Optimal Nutrition At First Bite: Identifying First Foods For Healthier Lifespans Julia Nordgren, MD, Chef Julia Nordgren, MD, Chef Palo Alto Medical Foundation Pediatric Lipid Specialist Pediatric Weight Management Specialist

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Optimal Nutrition At First Bite: Identifying First Foods For Healthier Lifespans

Julia Nordgren, MD, Chef

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Julia Nordgren, MD, Chef

Palo Alto Medical Foundation

  • Pediatric Lipid Specialist
  • Pediatric Weight Management Specialist
  • Pre-diabetes Program
  • Culinary Medicine Program

Culinary Institute of America DrJuliacooks.com

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Speaker Disclosure

  • Honorarium provided by the Hass Avocado Board
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First Foods Matter!

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Session Objectives

  • Amplify science findings to help improve knowledge among

health professionals and colleagues on best practices to follow when feeding infants and toddlers.

  • Counsel clients and the public on specific food combinations to

ensure toddlers and infants are exposed to appropriate textures and flavors, and are meeting nutrient needs.

  • Create tools and tips to help caregivers choose optimal foods

for their infants and/or toddlers to ensure they are building lifelong healthy eating habits.

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Outline

  • Why first foods matter
  • Goal for caregivers: Best Practices for Infant Feeding
  • Challenges of feeding infants healthfully
  • Strategies for optimizing for infant feeding
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First Foods Matter

It is no longer arguable that the foods that are introduced to a developing fetus and baby have long-term effects.

  • Physical development
  • Neurologic development
  • Feeding patterns and flavor preferences
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Physical Development

  • Infancy is a rapid stage of growth. Body weight is tripled

in the first year. Babies who don’t get adequate calories and nutrition suffer from stunting and developmental delays.

  • High nutrient requirements for all body functions.

Developing iron stores, immunity, gastrointestinal function.

Pediatric Nutrition Handbook, 6th edition, RE Kleinnman, ed. American Academy of Pediatrics, Elk Grove Village IL, 2009

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Neurologic Development

  • Brain growth: The brain doubles in size the first year, and

by age three has 80 percent of its adult volume

  • Rapid time of brain development; more synapses

created in first two years than any other time in life

  • Critical connections are made: hunger, satiety, comfort,

habits

  • These connections can influence quality of foods and

impact

Li Z, Sheng M. Some assembly required: the development of neuronal synapses. Nature Reviews. 2003;4:833-841

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Synapse Development

Corel, JL. The postnatal development of the human cerebral cortex. Cambridge, MA. Harvard University Press; 1975. Also see: http://www.urbanchildinstitute.org/why-0-3/baby-and-brain

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No Food in Mommy’s Car!

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Infant Feeding: Neurologic Connections

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Neurologic Connections: Hunger and Satiety

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Neurologic Preferences

  • Flavor Development. Offering very sweet or salty foods

will teach infants a preference for these foods.

  • Taste preferences: importance of repeated offering of

foods

Beauchamp, GK, Moran, M. Dietary Experience and sweet taste preference in human infants. Appetite, 1982.

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Importance of Setting Early Habits

  • Intake of fruits and vegetables at 1 year was strongly

associate with intake of fruits and vegetables at 6 years

  • Intake strongly influenced by repeated offering, parental

modeling, and parental response

Fruit and Vegetable Intake During Infancy and Early Childhood. Grimm et al, Pedatrics 2014;134, S63

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Variety Matters

  • The variety of foods introduced by age 6 months is

predictive of the variety of foods eaten at age 6 years

Fruit and Vegetable Intake During Infancy and Early Childhood. Grimm et al, Pedatrics 2014;134, S63

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Drinks Matter: Sugar Sweetened Beverages

  • Intake of sugar sweetened beverages at 1 year was

strongly associated with intake of SSB at 6 years

  • Sugar sweetened beverages are not nutritive, not

essential and contribute to overweight / obesity

The Association of Sugar-Sweetened Beverage Intake During Infancy With Sugar-Sweetened Beverage Intake at 6 Years of

  • Age. Park, S et al, Pediatrics 2014;134;s56
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Implications of Habit Setting

  • Most common foods offered outside of mealtime for

infants are cereals, crackers, cookies, and French fries

  • Vegetable and fruit intake drops off at 9 months
  • By one year of age, the most commonly consumed

vegetable is French fries

Food consumption patterns of infants and toddlers: where are we now? Siega-Riz AM, Deming DM, Reidey KC, Fox MK. J Am Diet

  • Assoc. 2010 Dec;110(12 Suppl):S38-51.
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Opportunity for Improvement

  • Children over 2 consume nearly 40% of their calories

from refined grains, sugar-sweetened beverages, and fruit juice

  • Infants and toddlers were much more likely to consume

sweets (cookies/ candies) than vegetables and fruits on any given day

Lessons from the feeding infants and toddlers study in North America: what children eat, and implications for obesity prevention. Saavedra JM et al. Ann Nutr Metab. 2013;62 Suppl 3:27-36. Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Complementary and Transitional Feeding. Nutrients, 2016, 8, 316.

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Time of Opportunity - Parents

  • This is an amazing window of opportunity to develop

and shape these important connections

  • Parents have more control and influence over their

child’s eating from birth to 24 months that at any other time in their child’s life

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Time of Opportunity: Doctors, Nurses, Nutritionists

  • We are a trusted source of information on how to best

feed infants

  • Parents are motivated and receptive to advice when

they feel encouraged and empowered

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What Clinicians Can Do

Positive Feeding Practices

Motivate Educate Provide Tools

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Best Practices: Complementary and Transitional Feeding

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Best Practices: Selecting First Foods

  • Texture: soft foods that are easily chewed and

swallowed

  • Rich in nutrients, antioxidants
  • Mild flavor for initial foods
  • Low in sugar and added salt
  • Whole, fresh good
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COST

Safeway or Sprouts – personal experience Whole foods

  • Sweet potatoes: 8 servings, $1.28
  • Carrots: 20 cents per serving
  • Green beans: 30 cents per serving
  • Mango: 50 cents per serving
  • Avocado: 30-60 cents per serving
  • Black beans: 5 – 10 cents per serving

Low nutrient or convenience food

  • Baby cheese puffs $3.49
  • Pureed Pouches: $1.49 per serving
  • Jarred foods: $1.25 each
  • Baby yogurt bites: 4.49 for 4 servings

(at whole foods)

  • Baby mango puffs $3.99 at whole

foods

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Specific Food Combinations

  • Fat-Soluble Vitamins and unsaturated fat sources

Vitamins A, D, E, K need fats for proper absorption Babies and toddlers should not follow a low-fat diet Avocado and pepper, carrot, tomato

  • Iron sources and Vitamin C
  • Meat (ground beef or chicken) and tomato, strawberries, etc
  • Iron absorption is aided by ingesting source of vitamin C at the same meal
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Pitfalls of Complementary and Transitional Feeding

  • Introducing solids too early: obesity link (6 months is

recommended)

  • Feeding for comfort instead of hunger (crying, fussing,

squawking does not always mean hunger!)

  • Offering empty calories (processed food, prepackaged

food, baby junk food)

uptodate.com/contents/dietary-recommendations-for-toddlers,preschool accessed 7/14/16

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Constant Feeding

  • Constant feeding interferes with hunger / satiety

development, interferes with proper tooth development, and sets the stage for adipose tissue development (e.g. feeding in car, stroller, in waiting room, exam room, car ride home)

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THANK YOU

To all of the wonderful mothers and friends who offered these images of their children And to Comadre for the Creative Direction on the Easel Project

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References

  • Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in

Complementary and Transitional Feeding. Nutrients, 2016, 8, 316.

  • Pediatric Nutrition Handbook, 6th edition, RE Kleinnman, ed. American Academy
  • f Pediatrics, Elk Grove Village IL, 2009
  • Fruit and Vegetable Intake During Infancy and Early Childhood. Grimm et al,

Pedatrics 2014;134, S63

  • The Association of Sugar-Sweetened Beverage Intake During Infancy With Sugar-

Sweetened Beverage Intake at 6 Years of Age. Park, S et al, Pediatrics 2014;134;s56Li Z, Sheng M. Some assembly required: the development of neuronal

  • synapses. Nature Reviews. 2003;4:833-841
  • uptodate.com/contents/dietary-recommendations-for-toddlers,preschool accessed

7/14/16