It is the position of the American DieteticAssociation that children ages 2 to

11 years should achieve optimal physicaland cognitive development, attain a

healthy weight, enjoy food, and reducethe risk of chronic disease through appropriate

eating habits and participationin regular physical activity.

Task 1: Concept DiagramWhy is nutrition in kids important?

Groups of 4

Draw a concept diagram

Consider the ADA position and AAP article excerpt provided

Include possible consequences, causes, contributors

Most circles = Prize

Pediatric Nutrition

Amanda Cuda, MD

Objectives

Developed concept of pediatric nutrition

Reviewed pediatric malnutrition syndromes

Reviewed age specific recommendations

Explored health behavior counseling

Exposed to national and local resources

Take Home

Inspiration

Choose Your Plate

Task 2: Matching Malnutrition Syndromes

Use worksheetWork aloneMatch the description to diagnosis or syndrome

Task 2: Answers

Marasmus Kwashiorkor Stunted Underweight Overweight/obese Anemia Rickets Scurvy Pellagra

• Starvation• Protein energy malnutrition• Low height for age• Low weight for height• High weight for height• Iron deficiency • Vitamin D deficiency• Vitamin C deficiency• Niacin deficiency

Age Specific Nutrition

• Prenatal– Primordial prevention– Iron supplementation if anemia – DHA = Evidence Grade C

• Birth – 2 years– Exclusive breastfeeding for first 6 months– Transition to other food sources at 4-6 months – Iron supplementation if anemia at 12 months– Fluoride supplementation if not in water supply and

have teeth– Primordial prevention

Age Specific Nutrition

• 2-5 years– Brushing = may not need fluoride any more– Most do not need multivitamin– Calcium, vitamin D, fiber in diet– Vitamin A supplementation considered in developing

countries– Primary prevention– DHA?

• 5-11 years, Adolescence– Primary prevention– Fiber

http://www.choosemyplate.gov/healthy-eating-tips/ten-tips.html

http://www.healthychildren.org/English/ages-stages/Pages/default.aspx

http://www.eatright.org/kids/

Task 3: Choose Your Plate

• Groups of 4• Menu from Pediatric Inpatient Nutrition Care• Bag of “food”• Task 3a: Order 3 meals by circling choices• Task 3b: Create a meal with food• Take 10 minutes• We will hear a sample

Low hanging fruit

• Replace SSB with H2O• Avoid the “whites”• Eat on a kid plate• Eat together at home• Take out or fast food 1/week• Shop on outside of grocery store• 1 fruit, 1 veggie at every meal

For Picky Kids

• Chocolate milk increased calcium• Presweetened cereals increased calcium,

folate, and iron• SSB, sugars, sweets, and sweetened

grains had a negative impact• More sugar consumed = fewer vegetables,

fruits, dairy, vitamin A, calcium, folate

Role of the RD

Provide technical assistance andtraining to practitioners that provide

nutrition-related services tochildren and adolescents in health

and education settings.

Nutrition Consults

• Lisa Lumpkin: 968-0547

• Janet Fabling: 4N/PICU

• Individual visits for kids

• Special needs over 18 years

Objectives

Develop concept of pediatric nutrition

Review pediatric malnutrition syndromes

Review age specific recommendations

Explore health behavior counseling

Expose to national and local resources

Task 4: Take Home Challenge

Apply 1 of the “low hanging fruit”

health behaviors for 1 month

Questions?

References

• Stang J, Bayerl CT; American Dietetic Association. Position of the American Dietetic Association: child and adolescent nutrition assistance programs. J Am Diet Assoc. 2010 May;110(5):791-99.

• Frary CD, Johnson RK, Wang MQ. Children and adolescents’ choices of foods and beverages high in added sugars are associated with intakes of key nutrients and food groups. J Adolesc Health. 2004;34:56-63.

• Ponza M, Devaney B, Ziegler P, Reidy K, Squatritio C. Nutrient intakes and food choices of infants and toddlers participating in WIC. J Am Diet Assoc. 2004; 104(suppl 1):S71-S79.

• World Health Statistics 2012, World Health Organization. http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_TOC.pdf

• Gidding etal. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics 2006;117;544 DOI: 10.1542/peds.2005-2374