Nutrition Programs for Children and Adolescents PDF

L 8 Nutrition Programs for Children and Adolescents Growing Older: Nutrition Assessment, Services, and Programs By: Dr. Awatif Almehmadi Nutrition Programs of the U.S. Department of Agriculture: 1 The National School Lunch Program. 2 The School Breakfast Program. 3 The After Scho...

L 8 Nutrition Programs for Children and Adolescents Growing Older: Nutrition Assessment, Services, and Programs By: Dr. Awatif Almehmadi Nutrition Programs of the U.S. Department of Agriculture: 1 The National School Lunch Program. 2 The School Breakfast Program. 3 The After School Snack Program. 4The Summer Food Service Program for Children. 5 The Food Distribution Program. 30  the U.S. 1- The National School Lunch Program Helps states make lunches available to children and encourages consumption of national agricultural commodities. Lunches must include the following: – 8 ounces fluid milk. – 2 ounces protein. – ¾ cup serving consisting of two or more vegetables or fruits or both. – 8 servings of bread, pasta, or grains per week. Nutrition Programs of the U.S. Department of Agriculture 2- The School Breakfast Program » Helps states provide a nutritious, nonprofit breakfast for children. » Breakfast must provide one-fourth of the daily recommended levels of protein, calcium, iron, vitamin A, vitamin C, and calories. » Breakfast can be either hot or cold. » Breakfast is served free or at a reduced price to students.  3- The After School Snack Program – This expansion of the NSLP provides repayment for snacks served to children, through the age of 18, in after school educational and enrichment programs. Nutrition Programs of the U.S. Department of Agriculture 4- The Summer Food Service Program for Children – Provides funds for eligible sponsoring organizations for the purpose of serving nutritious meals to needy children when school is not in session. – Sponsoring organizations include: » Units of local, county, tribal, or state government » Residential camps » Youth sports camps Nutrition Programs of the U.S. Department of Agriculture 5 The Food Distribution Program – Provides commodities to public and private nonprofit schools that serve meals to students. – School districts are given an entitlement dollar value based on the number of lunches served during the previous year.  Building Healthful School Environments – Many states and school districts are developing policies that limit the sale of competitive foods and less healthy food choices.  Empowering Teens to Make Better Nutrition Decisions “Food on the Run”. Recognized the importance of empowering teens to make better decisions about their diet, activity, and health. Goals and Objectives. Goal: Improve the health of high school students through: » Promotion of accurate nutrition information in the classroom. » Increased availability of healthful food options on campus. Target Audience Low-income students in high schools where at least 40% of the students were eligible for free/reduced-price meals.  Results – Student surveys and an assessment of the school environment. – Statistically significant increases observed for: Physical activity knowledge and attitude. Nutrition knowledge, attitude, and behavior. Healthy eating options. Healthy eating promotional efforts on school campuses. Physical activity options available to students at the schools. 40  Nutrition Education in the Public Sector Three nutrition education programming agencies have been the USDA’s: » Nutrition Education and Training program (NET). » Expanded Food and Nutrition Education Program (EFNEP) » TEAM Nutrition  Eat Smart. Play Hard. 5 a Day the Color Way VERB. It’s What You Do Powerful Bones, Powerful Girls Recommendations for Children and Adolescents. Eat three meals a day, with healthy snacks. Increase fiber in the diet and decrease the use of salt. Drink water. Try to avoid drinks that are high in sugar. Fruit juice can have a lot of calories, so limit your adolescent's intake. Whole fruit is always a better choice. Eat balanced meals. When cooking for your adolescent, try to bake or broil instead of fry. Make sure your adolescent watches (and decreases, if necessary) his or her sugar intake. Eat fruit or vegetables for a snack. Decrease the use of butter and heavy gravies. Eat more chicken and fish. Limit red meat intake, and choose lean slices when possible. Growing Older:Nutrition Assessment, Services, and Programs Overview Geriatrics – Gerontology. Changes associated with ageing. Nutritional requirements for elderly. Nutrition related problems among elderly. Community-Based Programs and Services. Supplemental Security Income (SSI). The Elderly Nutrition Program (ENP). Nutrition Education and Health Promotion Programs for Older Adults. Meals-on-Wheels program. 2  Introduction Old age is best defined as retirement age, that is 60 years and above. Nutrition for old age is known as Geriatric Nutrition. Aging brings physiological, psychological and immunological changes which influence of the nutritional status. Disease can shorten people’s lives and poor nutrition practices make diseases more likely to occur. 3  Geriatrics - Gerontology Geriatrics: the branch of the medicine dealing with health problems of the elderly. i.e. delaying the onset of severely degenerating aspects of aging and treating the disease of the aged. Gerontology: Broad area of science concerned with all the psychological, social, economic, physiological and medical problem of elderly. 4 Changes associated with ageing Physiological Changes. Loss of teeth. Decreased neuromuscular coordination. Impaired hearing and failing vision. Reduced sense of taste and smell. Anorexia. Physical discomfort. Change in body composition. 5 Changes associated with ageing Physiological Changes. Change in gastro-intestinal tract. Change in cardiovascular system. Change in respiratory function. Change in renal function. Change in skeletal tissue. 6 Changes associated with ageing Socio Psychological Changes. Food habit. Lack of nutritional knowledge. Economic aspects. Loneliness (Aloneness). Depression. Anxiety. Loss of self-esteem. Loss of independence 7 Nutritional Requirements for Elderly Energy: Energy requirement reduces. Basal metabolic rate decreases (15-20 percent) due to reduced muscle mass and other metabolically active tissue mass. Reduced physical activity. Increase in fatty tissue. Sedentary Moderate Male 1883 kcal 2216 kcal Female 1706 kcal 2007 kcal 8 Nutritional Requirements for Elderly Carbohydrate: Requirement reduces. Impaired glucose intolerance can lead to hypoglycemia, hyperglycemia, and type II diabetes mellitus. Insulin sensitivity can be enhanced by balance energy intake, weight management and regular physical activity. 50 percent energy should derive from carbohydrate. 9  Nutritional Requirements for Elderly Protein: Decreased skeletal tissue mass. Decrease in store of protein is inadequate to meet the need of protein synthesis. Intake of 1.0gm/kg is safe during old age. Curd Protein rich food with milk and curd should be included. Due to decrease appetite and poor digestion, old people consume less protein which may lead to edema, anemia, and low resistance to infections. 10 Nutritional Requirements for Elderly Lipid: Dementia and CVD may share risk factors like high intake of dietary total fat. Emphasis should be placed on reducing the intake of saturated fat and choosing mono saturated or poly saturated fat sources. Sufficient intake of ω-3 fatty acids helps in visual acuity, hair loss, tissue inflammation, improper digestion, poor kidney function and mental depression.  Minerals Calcium: 800mg/day Nutritional To compensate age related bone loss, to improve calcium balance and to decrease prevalence of Requirements fracture. for Elderly Ca absorption efficiency decreases, vitamin D level decreases so need more Ca. Total food consumption decrease so Ca supplements needed.  Minerals Iron: 30mg/day Nutritional Deficiency is seen in elderly due to inadequate iron Requirements intake, blood loss due to chronic disease or reduced non-heam iron absorption. for Elderly Vitamin C deficiency also reduce iron absorption. Mild anemia affect health due to less efficient circulation of blood. Nutritional Requirements for Elderly Minerals Zinc 11 mg/d Some features like delayed wound healing, decreased taste sensitivity and anorexia are associated with zinc deficiency. But healthy elderly don’t show zinc deficiency. Nutritional Requirements for Elderly Vitamins: Elderly are at risk of Vitamin D deficiency due to decreased exposure to sunlight or decrease in renal mass. Dietary supplements with calcium and vitamin D improves bone density and prevent fractures. Parkinson disease People with Parkinson disease have low vitamin D levels.  Nutritional Requirements for Elderly Vitamins: Stress, smoking, and medication can increase vitamin C requirement. The antioxidant vitamins such as vitamin E, carotinoids and vitamin C enhances health of elderly. Vitamin C may be protective against cataract at an intake level of 150-250 mg/day. Vitamin E is potent nutrient for reducing decline in cellular immunity that occur in elderly.  Nutritional Requirements for Elderly Vitamins: Changes in immune system can be overcome by taking 200 mg of vitamin E. Requirement of vitamin B6 increased due to atrophic gastritis, absorption lacking. Alcoholic and liver dysfunction are additional risk factor for deficiency of vitamin B6. Vitamin B6 have significant role in immune system.  Nutritional Requirements for Elderly Vitamins: Alcoholism is a risk factor for folate deficiency. Severe deficiency of folic acid may result anemia and elevated serum homocystiene level which is a risk for cardiac diseases. Consumption of folate rich food is needed. Causes for vitamin B12 deficiency are atrophic and bacterial overgrowth, which decreases absorption and leads to pernicious anemia.  Nutrition Related Problems Among Elderly Obesity. Under nutrition and malnutrition. Osteoporosis. Cardiovascular diseases. Diabetes. Cancer National Goals for Health Promotion Primary Healthy People 2020 objectives for older adults focus on reducing the prevalence and number of people who suffer from some of the following: Osteoporosis Arthritis Cancer Diabetes Kidney disease 20  Evaluation of Nutritional Status Up to one-half of all hospitalized elderly may be suffering from malnutrition. Nutrition Screening A number of specific risk factors and indicators of poor nutrition status in the elderly have been identified and incorporated into a checklist to be used at any office or agency for the elderly. The checklist addresses: Disease Eating status Tooth loss or mouth pain Economic hardship Reduced social contact Multiple medications Involuntary weight loss or gain Need for assistance with self-care Elder years above age 80  Mini Nutritional Assessment (MNA) Tool Screening and Assessment tool for the identification of malnutrition in the elderly Considers: Dietary Intake – foods, patterns. Weightchange, BMI, Muscle circumferences. Functional impairment. Independence. Living arrangements. Psychological issues. Self-assessment. Short Nutritional Assessment Questionnaire (SNAQ) To get an vision into patients’ nutritional status. The quick and easy-to-use screening tools: SNAQ: for hospitalized patients. SNAQRC: for the elderly in care homes or housing care. SNAQ 65- : for patients in the community who are aged 65 and under. SNAQ 65+: for patients in the community who are aged 65 and over. Nutritional Assessment ❖Anthropometric measures include height, weight, and skinfold measures that are affected by aging. ❖Clinical assessment evaluates condition of the hair, skin, nails, and other physical attributes. ❖Biochemical assessment may include serum albumin because low serum albumin levels are associated with increased morbidity and mortality in the elderly. ❖Dietary assessment Include food diary (3 or more days), food frequency or 24-hour recall. ❖Medication assessment notes the types and doses of prescription and evaluates possible nutrient-drug interactions. ❖Social assessment examines financial resources, living arrangements, and social support. Community-Based Programs and Services General Assistance Programs Supplemental Security Income (SSI) program - improves the financial difficulty of the very poor elderly. Benefits to meet the financial limits for: Adults Children Older peoples Community-Based Programs and Services. Nutrition Programs of the U.S. Department of Health and Human Services: The Elderly Nutrition Program (ENP) ENP is intended to improve older people’s nutrition status and it has goals to provide the following: Low-cost, nutritious meals. Opportunities for social interaction. Nutrition education and shopping assistance. Counseling and referral to other social and rehabilitation services. Transportation services. 40  Community-Based Programs and Services. The Elderly Nutrition Pogram (cont.) One hot meal a day, that provides a third of the RDA, is provided five days a week through the Congregate Meals Program of ENP. Another component of ENP is the Home- Delivered Meals Program that delivers meals to those who are homebound. Community-Based Programs and Services Nutrition Education and Health Promotion Programs for OlderAdults – New programs are being developed to reach seniors, especially those living in rural areas. – The Food Marketing Institute has developed To Your Health!, a program that offers a supermarket group that provides program planners with tools and ideas for promoting healthy eating and activity habits of older shoppers. Community-Based Programs and Services Private-Sector Nutrition Assistance Programs. Meals-on-Wheels program - a national project operated by local volunteers who provide home-delivered meals to older adults.