Ruth Charles
Consultant Paediatric Dietitian
Whole family nutrition, heart health
& meal planning:
focus on differing needs and limited
budget
Ballinderry Clinic, St. Francis Hospital, Mullingar, Co. Westmeath.
www.nutrikids.ie
Life ages and stages
Ruth Charles MINDI
Stage
Key drivers for nutrition
Nutrition related issues
Key nutrients
Infant
0-12 months
Growth: linear and weight gain
Bone Health
Blood Health
Anaemia
Food refusal
Toddler
1-4
Family Diet
Independence
Physical activity
Food refusal
Dental health
Calories
Iron
Calcium
Vitamin D
Child
5-13
Linear Growth
Peers
Sport & hobbies
Overweight & obesity
Calorie quality
Teen
14-18
Growth spurt
Puberty
Menstruation
Bone Health
Fad diets
Imbalance
Drugs and alcohol
Role models +/-
Calorie quality
Iron
Calcium and
Vitamin D
Adult
18-51
Weight:height
Waist circumference
Pregnancy & lactation
Physical activity
Overweight
Metabolic Syndrome
Irritable bowel syndrome
Cancer
Stroke
Coronary Heart Disease
Calorie quality
Folic acid
Calcium and
Vitamin D
Over 51
Muscle mass declines
BMR drops
Anorexia
Physical activity
Osteoporosis
Fractures
Calorie quality
Calcium and
Vitamin D
Ruth Charles MINDI
Fibre
Nutrient requirements
Ireland
Infants
NEW
RECOMMENDATION
Vitamin D3
supplement:
Children 0-1 year:
5µg/200 i.u.
Ruth Charles MINDI
Nutrient requirements Ireland
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Food refusal
• Common
• Learned behaviour that’s
repeated if the desired
result is obtained
• Keep trying! 10-15 new food exposures required
before acceptance
• Do you eat the food? Be a good role model.
• Eating at the same time. Eating new foods
together. Sitting together at the table.
Ruth Charles MINDI
Iron deficiency Anaemia
Adults: Red meat 2-3 times a week
Infants & children: Include red meat in the weaning diet from 6 months onwards
Avoid giving tea
Avoid too much formula/milk (>6oomls reduces appetite for
other food)
Follow on infant
formulae
Ruth Charles MINDI
Bone health: Calcium (Phosphorus)
• Dairy: 3-5 servings per day for children. 5
servings a day for teenagers.
Pregnant/breastfeeding women 3 servings.
• Serving= glass of milk (1/3 pint or 189 ml), 1
pot of yogurt or a matchbox-sized (1oz) piece
of cheese.
• There is relatively no difference in the calcium
content between full fat, low-fat and skimmed
milk.
Ruth Charles MINDI
Bone health Vitamin D
Active form cholecalciferol D3 needed.
Non Food sources:
5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to
the face, arms, legs, or back
Dietary sources: Most margarines
Some fortified brands of soya milks, yogurts and desserts – check the label
A few fortified breakfast cereals – check the label
Dried skimmed milk
Fortified yoghurts
Eggs
Oily fish: mackerel, herring, tuna, salmon
Ruth Charles MINDI
Dental Health
Ruth Charles MINDI
The facts
Report of the National Taskforce on Obesity 2005 : 1 in 5 children were
overweight
Growing Up in Ireland - Overweight and Obesity Among 9-Year-Olds 2011
370,000 Irish Children are Obese.
Girls
Overweight
11.6%
Obese
Boys
Overweight
Obese
13%
10.5%
9.2%
1 in 4 nine year olds are overweight/obese.
This number increases by 10,000 annually.
The World Health Organization (WHO 1998) report shows that the prevalence of
both adult and childhood obesity has reached epidemic proportions worldwide.
The changing shape of Irish children
Ruth Charles MINDI
What is the Metabolic syndrome?
9
8
7
6
Blood
glucose
5
4
Insulin
3
2
1
0
1
2
3
4
5
10
9
8
7
6
5
4
3
2
1
0
Blood
glucose
Insulin
1
6
3
5
7
9
•Your body becomes resistant to its own
Insulin
•Your own Insulin becomes ineffective
Ruth Charles MINDI
Waist circumference >37”M, >32”F
Ruth Charles MINDI
Low glycaemic index
High glycaemic index
Mixing a high with a low GI food reduces the overall GI
Ruth Charles MINDI
Heart Health
Ruth Charles MINDI
Heart Health
Risk factors
• Male
• Family History
•
•
•
•
•
•
Smoker
Stress
Blood pressure
LDL cholesterol
Weight
Cardiovascular fitness
Ruth Charles MINDI
Making sense of cholesterol and triglycerides
Ruth Charles MINDI
What are “omega” fats?
Cannot be made by the body
Must be eaten: omega 3 & 6
Reduced risk of coronary heart disease:
Reduce the stickiness of blood
Thin the blood
Protect blood vessel walls
Reduce Triglycerides
Reduce Inflammation
Maintain healthy bone joints
Ruth Charles MINDI
Ruth Charles MINDI
How healthy is your bowel?
What’s normal ?
What colour is normal?
Ruth Charles MINDI
Foods for gut and bowel health
Ruth Charles MINDI
Are you getting enough to drink?
Water
Milk
Pure Juice
Diluted squash
(Alcohol)
(Tea/Coffee)
(Fizzy drinks)
Ruth Charles MINDI
Where are we getting our calories
from?
Ireland 2012
Ireland 1970
Carbohydrate
(mainly natural high
fibre sources)
Fat (mainly natural
sources from dairy
and meat)
Carbohydrate
(mainly high
sugar/refined)
Fat (mainly
saturated)
Alcohol
Alcohol
Ruth Charles MINDI
Calorie quality: carbohydrate
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Calorie quality: Fat
• Saturated
• Polyunsaturated/
• Monounsaturated
• Oily fish 2-3 times per
week.
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Calorie quality: alcohol
1SD=70calories
Low risk weekly guidelines for adults are:
up to 14 standard drinks (980 kcals)in a week for women, and
up to 21 standard drinks (1470kcals) in a week for men.
Ruth Charles MINDI
Ruth Charles MINDI
At least one hour of moderate
intensity every day
Ruth Charles MINDI
Common recurring themes
A role in
More wholemeal, wholegrain, oats
Bowel health, Cholesterol reduction
Satisfying hunger, Low glycaemic index
More seasonal multicoloured fruit and vegetables.
Natural antioxidants: cancer and heart health
Soluble fibre for bowel health, Water soluble
vitamins, Low glycaemic index
Value for money
More fish especially oily sources
Omega fats for heart health
Choose lean red meat cuts
Haem iron for blood health
More pulses, nuts, seeds
Fibre for bowel health, Good source of protein and
minerals, Low glycaemic index
More fresh home cooked food
Basic cooking skills
Weight management, Low fat cooking methods,
Reduced salt
Life skills, Value for money
More water
Hydration, Dental health, Satisfying hunger
Dairy is good
Bone health, Low glycaemic index, Dental health.
Good source of protein. Value for money.
Physical activity
Agility, co-ordination, mood, heart health, weight
management
Ruth Charles MINDI
Common recurring themes
A role in
Less top shelf food pyramid
1-2 per week
Improved: Weight management, Heart Health &
Dental health
Cost of living
Less processed food, ready meals, takeaways.
Reducing salt intake, Improved Weight
management & Heart Health
Cost of living
Less added sugar, less added salt
Dental health, glycaemic index,Blood pressure
Alcohol in moderation
Improved Weight management & Heart Health &
general health
Cost of living
Learn to read food labels
Making better food choices
Ruth Charles MINDI
Ruth Charles MINDI
Free resources
• www.healthpromotion.ie
• www.irishheart.ie/media/pub/kids/on_the_go
_booklet_final.pdf
• www.littlesteps.eu
• www.fooddudes.ie
• www.indi.ie
• www.mabs.ie
Ruth Charles MINDI
Thank you
www.nutrikids.ie