It is the position of the American Dietetic
Association that children ages 2 to
11 years should achieve optimal physical
and cognitive development, attain a
healthy weight, enjoy food, and reduce
the risk of chronic disease through appropriate
eating habits and participation
in regular physical activity.
Task 1: Concept Diagram
Why 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 worksheet
Work alone
Match the description to diagnosis or
syndrome
Task 2: Answers
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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
 Marasmus
 Kwashiorkor
 Stunted
 Underweight
 Overweight/obese
 Anemia
 Rickets
 Scurvy
 Pellagra
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
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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
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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 and
training to practitioners that provide
nutrition-related services to
children 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
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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