From the Center on Disease Control… One out of seven low-income, 2 to 4 year old children is obese, however the obesity epidemic may be stabilizing 12.4 percent in 1998 14.5 percent in 2003 14.6 percent in 2008
What results in healthy weight? ENERGY BALANCE Energy Intake = Energy Expenditure
Co-regulation aids Self-regulation Know what food to offer Know what skills a child is learning and developing
What is Self-Regulation for a Young Child at Mealtimes? Awareness of internal cues of hunger and fullness Self-mediated response to food and behaviors for choosing how much to eat, serving self, and eating food
Supportive Strategies Support children as they choose amounts (portion sizes, judging amounts) Offer safe, developmentally appropriate food Offer effective comments that support learning
Strategy Support children as they choose amounts and foods
Basic Principle Children choose how much, or whether they eat (Satter, 1987)
Size Small pieces require less chewing, but may demand precise movement to place food between teeth
Shape Contours of the food impact the ease of placing the food between the side teeth for biting
Resistance Amount of pressure or force required to bite through food, and chew it into pieces
Sensory input Type and intensity of taste (Crunchy, spicy, sour, bitter, and cold are strongest inputs)
Texture Scatter Texture scatter is how food breaks up when a child bites into food
Texture Scatter Some foods break into pieces that don't bind together easily… pieces scatter into separate pieces that are not easily rolled into a bolus for swallowing
Texture Scatter Easy bolus formation (animal crackers, graham crackers, saltine crackers, cooked fruit and vegetables) Some bolus formation (goldfish crackers, bread, toast, sandwiches, hamburger on bread) Little to no bolus formation (hamburger, raw carrots, nuts, grapes, apple peelings, marshmallows, hard candy)
A young child lacks coordination of tongue and cheek and may leave pieces of food scattered randomly on the tongue. Gagging and choking may result from this type of scatter.
Consistency Food consistency is the texture of food The easiest foods to eat have a single consistency
Consistency Multiple consistency foods require several sensory inputs during biting, and different handling for each texture
Placement for chewing Food is placed in three teeth locations based on size, shape, resistance Front: central incisor teeth Mid-Side: canine teeth Side and back: molar teeth
Transfer Amount of chewing needed to move food to the opposite side of the mouth
Children need opportunities to try different types of food to help them develop skills
Choking!!! Avoid food that is round and firm, sticky, or cut into large chunks Food should be no larger than ½ inch in diameter for preschoolers and ¼ inch for toddlers
Reduce Choking Risks Adults should sit with and eat with children Model safe eating Serve food that is developmentally appropriate for children to chew and swallow
Reduce Choking Risks Encourage small bites Encourage chewing completely Insist on children sitting
AVOID THESE FOODS Nuts Seeds Whole berries Raw carrots and celery Firm, hard raisins Grapes (unless cut in half or quarters) Hot dogs Popcorn Hard candy Chunks of peanut butter Large chunks of meat or cheese
What you say matters… The aim is competent, successful children Be intentional and purposeful about what to say to encourage and reinforce children’s skills.
Types of Comments Neutral comments Impartial/no particular support offered Adult says, “Uh huh. I see that.”
Types of Comments Person-centered comments Focus on characteristics of a child Adult says, “You are such a big girl.”
Types of Comments Achievement-centered comments Focus on quality of behaviors of a child Adult says, “You are the best veggie eater in the whole family.”
Types of Comments Effort-centered comments Focus on a child’s attempts at a behavior Adult says, “You were brave. You worked hard to get up courage to try those beets even though you had never tasted them before today.”
Types of Comments Process-centered comment Focus on what the children do as they practice a behavior Adult says, “You picked up that beet. You smelled it. You tasted it. You took a bite, and then, you chewed it up, and you said you liked it. You are learning to try foods you’ve never tried before.”
Which comment type is most effective? …older than five years PROCESS-CENTERED MOST EFFECTIVE
Should I ever take over the child’s choice of deciding how much or whether to eat child’s choice of deciding how much or whether to eat? NO…
Adults decide what is presented to eat and how it is presented Children are sometimes picky about what they eat. Children do not easily take to unfamiliar foods Children are finicky, resistant, don’t like it, waste it, won’t touch it, eat only _____. Should I hide _____ in other foods?
Children should serve themselves So….can children really serve themselves? What must we do to make this happen? How old must children be to serve themselves? What strategies work? Isn’t it too messy? Won’t children waste food?
Children Can Serve Themselves A sequence of skills must be learned
Children Can Serve Themselves It will be ragged!
Portion Sizes What do young children need to know about portion size?
Portion Sizes and Healthy Eating Three-year-old children pay attention to internal cues Four-year-old children respond to portion size
Portion sizes and healthy eating Children should serve themselves
Working with staff Staff don’t want to eat their lunch with the children. Eating with children is gross. We’re too busy at that time of day to do all of this stuff. Just get the food into the children, then let’s do the real stuff of the day. I’m on a diet so I can’t eat with the children.
Thank you for thinking about helping young children maintain healthy weight