Place Headline hereFOODcents®: Important findings on

Incorporating Healthy Eating & Budgeting into Youth & Family

ProgramsJane Holmes and Lisa Maunsell

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Young Parents Program & FOODcents® Health, nutrition, food insecurity & young people

Some case studiesMain findings Conclusion

33Young Parents Program (YPP)

The program aims to break the cycle of abuse & neglect through prevention and early intervention.

The goal: young parents & their children reach their full potential within safe, strong, resilient families.

YPP works to ensure best outcomes for children & families by building capacity of very young parents aged 13 to 25 to live & parent independently & respond appropriately to the needs of their children.

44YPP approach

Strengths based, trauma informed, early intervention approach providing case management, access to parent education & academic pathways.

3 stages:- Residential, Outreach, Aftercare - Regional and Metropolitan

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• trauma, abuse & neglect• unstable/unsafe home environment• homelessness• drug & alcohol misuse• domestic & family violence• complex mental health issues & behaviours• limited or no healthcare• poor health• early disengagement from education (as early as primary school)• poor literacy & numeracy skills • limited family support & social networks• limited experience of positive parenting & role modelling• high risk of food insecurity

Our clients

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Food safety, healthy eating, recipe modification & healthy cooking methods, budgeting & shopping skills, benefits of exercise, nutrition requirements of pregnancy & early childhood.

Each session includes a cooking component.

FOODcents®

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• Improve compliance with Dietary Guidelines for Australians

• Increase fruit & vegetable consumption• Improve budgeting & planning skills

around food • Assist young parents to model healthy

food behaviours for their children• Focus on the appropriate use of food,

based on knowledge of basic nutrition & care

FOODcents® program goals at YPP are to:

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Whenever the availability of nutritionally adequate & safe foods or the ability to acquire acceptable food in socially acceptable ways is limited or uncertain.1

Associated with general poor health, and may worsen other health inequalities … such as higher mortality rate, higher rates of CHD, type-2 diabetes, & some cancers.2

Poor nutrition is associated with low birth weight & ill health in infancy & childhood. 3

6.3% of parents or carers of children 0-15years (NSW Child Health Survey 2009-10)

15% of young people (NSW Child Health Survey 2009-10)

40% average - as reported YPP FOODcents®1. Radimer, K. (2002). Measurement of household food security in the USA and other industrialized countries. Public Health Nutrition, 5(6A), 859– 864. 2.Turrell, G., & Kavanagh, A. M. (2005). Socio-economic pathways to diet: Modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutrition, 9(3), 375–383 3. Browne, J., Laurence, S., & Thorpe, S. (2009). Acting on food insecurity in urban Aboriginal and Torres Strait Islander

communities: Policy and practice interventions to improve local access and supply of nutritious food.

Food insecurity

99Adolescents’ nutrition behaviour

• Increased dopamine levels • Calcium absorption & gaining bone density 4.

• Iron • Low breastfeeding duration rates• Increased susceptibility to addiction 5. • Families from low socioeconomic backgrounds less likely to engage in healthy eating patterns (more high energy density, nutrient poor foods)

4. National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.

5. Siegel, DJ 2013, Brainstorm: the power and purpose of the teenage brain. Melbourne: Scribe.

1010Implications of poor nutrition on infants

• Introduction of solids too early can be critical• Physical & neuro-cognitive development is affected

by poor diet• By 3 years brain is 90% of adult size; & children

pre-disposed to the eating behaviours of future life• Breastfeeding risk of overweight/obesity which

may lead to chronic diseases later in life 6.

6. NHMRC (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.

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Frequent shared family meals are an important strategy in ensuring both the physical & emotional health of family members & the ongoing resilience & happiness of the family.

Evidence shows planned family meals: • promote regular meal times & routines that encourage less

snacking between meals. (7. Fruh et al. 2011)

• may act as a protective factor for many nutrition-related health problems during childhood & adolescence (8. Hammons and Fiese 2011).

The role of role modelling

7. Fruh, SM, Fulkerson, JA, Mulekar, MS, Kendrick, LAJ & Clanton, C 2011, ‘The surprising benefits of the family meal’, The Journal for Nurse Practitioners, vol. 7(1), pp. 18–22.8. Hammons, A & Fiese, B 2011, ‘Is frequency of shared family meals related to the nutritional health of children and adolescents?’, Pediatrics, vol. 127(6), p. e1565.

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• Introducing solid foods too early• Introduction of inappropriate/harmful foods• Regular provision of nutrient-poor foods• Not implementing/maintaining feeding schedules• Impact of low literacy/numeracy on feeding• Lack of understanding of babies’ nutrient

requirements & their own nutrient requirements• Peer role modelling around infant feeding &

engagement in cooking & food preparation has been observed to have a positive effect

Caseworker observations:

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Caseworkers, volunteers & mentors provide young parents with practical support eg. meal preparation,

developing meal plans, gardening, shopping & budgeting on a daily basis.

Experiential learning

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• Practical support at meal times • Junk food night• Progress tracked through case planning • Volunteers eg. Rob’s Friday night cooking group• Vegetable gardens• Food as a celebration• Play group – food as learning • Food & child development – intro. to solids• Breast feeding – maximise do not pressure • Pregnancy health & antenatal care • Values & judgement – ‘good enough nutrition’

In the house…

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Amanda & RubySally & JamieSasha & Daisy

Case studies

‘Smooth peanut butter is OK, it doesn’t have peanuts in it’

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1. Crunchy foods used to stimulate emotional self-regulation, reduction of tension in the infant’s mouth, behavioural management, & strengthened facial muscles used in speech.

2. Low literacy & numeracy skills led to the inability to tell the time and provide regular bottle feeds.

3. Inappropriate introduction of solids & fluids resulted in ongoing health problems for the child’s kidneys and digestive function.

Case studies in short……

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• 106 participants from 2010• Regional & metropolitan • Aboriginal & Torres Strait Islander people: average 22%• ‘Food insecure’: average 40% …..very high!• ‘Diet has improved’: 50% - 75%• confidence in cooking: up to 75% • confidence in budgeting & shopping• Food literacy: knowledge ranged from between 16% to 67%• frequency of consumption of takeaway food:13-75% rarely/never• frequency and no. of serves of fruit • Vegetable intake: frequency not as strong for number of serves• Legume intake: frequency & acceptance

Most improvements seen in young people in residential stage

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Feedback ‘I thought carrot soup would be really disgusting, but I really liked it!’ ‘That’s cool, now I can actually tell what the label means!’ ‘The high fibre pasta tastes just the same as the normal one.’ ‘I used to hate cooking but now I’m starting to enjoy it.’ ‘I like to experiment more now.’ ‘I totally always buy based on what the packaging looks like and what food looks healthy from the packaging, now I know how to tell if it really is good for your or not.’

1919Main findings

Time allocated to nutrition education & cooking skills must be prioritised for learning & behaviour change to be effective.

Role modelling is important; caseworkers, volunteers & staff need to have basic nutrition knowledge & cooking skills to be able to build capacity among young people to achieve positive health outcomes for themselves and their children.

The enjoyment experienced through cooking & eating together regularly as a family promotes positive social, emotional, cultural physical wellbeing.

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Challenges exist around environmental factors, extended families’ and peer influences on the food choices the young parents make.

Delivery of food and nutrition messages to young parents should be consistent and well informed, support experiential learning and acknowledge the differences between the young people’s living situations.

Young parent’s ability to model good eating behaviours can enhance the health and wellbeing of their children and each other.

Reflections and conclusion

2121Questions?