day care nutrition in a...

Day Care NutritionIn A NutshellTraining Review Module

2 Clock Hours

P.O. Box 5465, Katy, TX 77491 Tel: 281.395.7000; Toll- Free: 877.395.6560 Fax: 281.0395.7002 www.childfoodprogramoftexas.org

Instructions for completing this module:

1. After reviewing this material with your day home rep-resentative, please read and study the material carefully.

2. Complete the test for the material and return it toChild Food Program of Texas at your convenience. Thereis no deadline to have this test back to us,

3. When we receive your completed test, we will evalu-ate it and then send you a certificate for 2 clock hoursfor completing this material.

Objectives for this module:

1. To identify why we eat and what: we eat.

2. To educate family day care providers on the sixgroups of nutrients.

3. To help family day care providers identify poor nutri-tion in children through specific signs and symptoms.

4. To identify the specific nutritional requirements ofchildren.

The goals of the Nutrition Education andTraining Program are to:

1. create an awareness of the importance of nutritionand nutrition education, and

2. promote changes in eating patterns that will result inhealthier children.

Table of Contents

Food Choices: Why do we eatwhat we eat? ........................................................... Page 3Fuel For Life: Food and energy ............................ Page 4What Is Food? The six groups

of nutrients ...................................................... Page 5Poor Nutrition In Children. Symptoms

to look for ........................................................ Page 10How Much Is Enough? Nutritionalrequirement of children ........................................ Page 12

Food Choices:Why do we eat what we eat?

You choose foods for many reasons. You eat becauseyou’re hungry and you choose foods because they areavailable. Rarely is food chosen for its nutritional value.You choose food for yourself and your family becausethe food tastes good, because you associate it with pleas-ant past experiences, or because you see it as a statussymbol.

Every year the food industry spends millions of dollarsto promote foods with little or no nutritional value. Achild may see as many as 300 TV commercials for food,drinks, and candy during one week, but rarely will thatchild see a commercial for fruits, vegetables, or wholegrain breads and cereals. How can children learn to makewise food choices when so many advertisements encour-age the selection of non-nutritious foods? As a consumer,you can make a difference. The food industry producesand advertises foods that sell. If you spend your fooddollars on nutritious foods, you’ll make a difference inwhat is advertised and available at the grocery store.

Good eating habits don’t just happen, they must belearned. The strongest influences on a child’s eating hab-its are parent attitudes and behaviors, particularly thoseof mothers. A child’s first teachers also affect the devel-opment of eating patterns. A teacher with a positive atti-tude about food may increase a child’s acceptance andenjoyment of new foods.

Children’s nutritional status depends on their acceptanceof a variety of foods. During a child’s preschool years,day care workers have a chance to affect lifetime foodhabits. With your leadership, motivation, and encourage-ment, children in your care can learn about nutritiousfoods and develop healthy eating habits. You shouldpresent this nutrition education in an exciting and mean-ingful way, because not until children establish soundeating habits can nutrition education be called successful.

Fuel For Life:Food And Energy

The most important reason for eating is to supply energyto the body. Just as a car needs gasoline for fuel, yourbody needs food.

As food is burned in your body, energy is produced andheat is released. This process is metabolism. Your bodyuses the energy from food for physical activity and main-tenance of body processes. The more energy a food pro-vides, the more heat it releases. A calorie is the unit usedto measure the energy, or heat, a food supplies.

The human body is a nonstop energy consumer. You useenergy when you breathe, when your heart pumpsblood, and when you digest food. You use energy whenyou walk, run, or exercise. During times of rapid growth,or recovery from illness or injury, children need extracalories. Children may fail to grow and develop normallyif they don’t get enough food and they may even lose

weight. Although their bodies and appetites may besmaller, children’s energy requirements may be equal tothat of mature women. Because of their small appetites,children need to eat often. This is why the Minimum Stan-dards for Day Care Centers and Family Day Homes describea meal pattern which includes a mid-morning and mid-afternoon snack for children.

To maintain a healthy body weight, you must use asmuch energy as you take in. Unlike a car, your body hasno gas tank that overflows when it gets too much fuel.The body will process as many calories as you choose togive it, and the food not used for energy will be stored asfat. If excess food is eaten every day, overweight and obe-sity will occur. Physical activity is one good way to avoidthese problems.

What Is Food?The Six Groups Of Nutrients

All foods contain one or more of the six nutrients: pro-tein, fat, carbohydrate, vitamins, minerals, and water. Allare equally important. Each is essential for life, health,and vitality, and each has a special function in the body.

Protein: The body’s building blocks

Every cell in the body uses protein. Bodies use protein tobuild and repair skin, muscles, and connective tissue, andto make body fluids such as blood. Proteins also helpregulate body processes and help the body resist infec-tion. Protein requirements increase during periods ofrapid growth and recovery from illness.

Complete and incomplete protein

Protein is made of building blocks called amino acids.When you eat foods containing protein, two things hap-pen: first, your body breaks the protein into amino acids,and second, the cells rearrange the amino acids to buildthe proteins they need for growth, maintenance of tis-sues, and regulation of body functions.

There are eight amino acids you must get from foods.These are essential amino acids. Although your body re-quires other amino acids it can make these itself if youeat enough of the essential amino acids.

The protein in animal foods is complete because it con-tains the eight essential amino acids. The protein in plantfoods is incomplete because some of the essential aminoacids are missing or present in small amounts.

Meatless menus can supply complete protein if they arecarefully planned. By combining the incomplete proteinin one plant food with the incomplete protein in a differ-ent plant food you can get a complementary protein.Complementary proteins are equal in quality to the com-plete protein found in meat. Examples of complementaryproteins using plant foods are corn tortillas with beans,peanut butter with bread, and lentils with barley soup.You can also combine an incomplete plant protein with asmall amount of complete animal protein to produce acomplementary protein. Examples of complementary

proteins using plant with animal foods are milk with ce-real, macaroni with cheese, and eggs with rice casserole.These familiar foods provide good sources of proteinwhen eaten in the combinations described. Ask a nutri-tionist about other ways to combine foods for adequateprotein.

What are the best sources of protein?

Protein is concentrated in the animal foods-meat, fish,poultry, eggs, milk, and cheese. Other less expensive pro-tein meat alternates will supply adequate protein sourcesare legumes (dried peas and beans), nuts, seeds, and pea-nut butter.

How much is enough?

As previously mentioned, protein is an especially impor-tant nutrient for growing children. Two servings a day ofmeat or meat alternates will supply adequate protein formost healthy children. The serving size increases as achild grows. For child size portions, refer to “Meal Pat-terns for Children” available from the workshop leader.

Although protein is essential for growth and mainte-nance of body processes, you can overdo a good thing.Protein-rich foods are usually the most expensive itemson the grocery list. The dietary protein not used to main-tain or replace the body’s protein will be burned for en-ergy or converted to fat and stored. This is an expensiveway to provide the body with energy, and you can getfat. Most animal protein foods contain a lot of saturatedfat. The potential danger of too much saturated fat is de-scribed in the next section.

Fats: The energy that lasts

Although dietary fat is considered a weight watcher’senemy, it’s also an essential nutrient. Besides carryingvitamins A, D, E and K, fat is digested slowly and there-fore delays hunger between meals. Fat is also needed tomaintain healthy skin.

Fat is a concentrated energy source and supplies alarge number of calories in a small amount of food,as shown by this comparison:

1 teaspoon fat = 35 calories

1 teaspoon sugar = 15 calories

Because fat is so concentrated, it’s a good way to addcalories to diets of small children with limited appetites.For example, margarine can be spread on toast or muf-fins, added to cooked cereals, or used to season steamedvegetables. Calorie conscious dieters, however, mightrestrict dietary fat to reduce caloric intake.

Fats have two classifications: polyunsaturated fats areusually liquid at room temperature, and include veg-etable oils, mayonnaise, and margarine. Saturated fatsare solid at room temperature, and include butter, lard,shortening, and fat in meat and cheese.

After digestion, saturated fat may accumulate in the ar-teries as a hard substance called plaque. Increasedamounts of plaque may clog the arteries and lead to arte-riosclerosis and other forms of heart. disease. Heart dis-ease is the leading cause of death in this country. Al-though other factors may cause heart disease, a diet con-taining more polyunsaturated fat and less saturated fatreduces the risk of heart disease. Such a diet is recom-mended for people of all ages, including preschoolchildren.

Protein foods from animal sources often contain “hid-den” saturated fat. Try to choose those protein foodslowest in saturated fats. (See the following list.)

Foods low in saturated fats:eat these foods more often

ChickenTurkeyFishRound steak / Sirloin steak (trim all outside fat)Cottage cheeseYogurtLow fat or skim milkButtermilkMargarine: liquid vegetable oil first ingredient on labelVegetable oilIce milk or sherbet

Foods high in saturated fats:eat these foods less often

HamBaconGround BeefHot dogs bologna or salamiSausagePork chopsCheese: cheddar, Swiss, processedCream cheeseWhole milk ButterShortening or lardIce cream

What foods contain fat?

Dietary fat sources include oils and shortening, butterand margarine, whole milk and cheese, nuts, seeds, andfatty meats. More than 50 percent of the calories inground meat, frankfurters, bologna, ham, bacon, andsausage come from fat.

What about cholesterol?

Cholesterol is a fatty substance found in animal foodsand the human body. Eggs, butter, cheese, liver, and theshellfish contain a lot of cholesterol. Adults diagnosed ashaving an increased risk of heart disease should restricttheir intake of these foods. They may be used in modera-tion in the diets of children.

Carbohydrate: Foods for quick energy

Carbohydrates are nutrients found primarily in plantfoods. The body uses carbohydrates for energy and forprocessing fats and proteins. During digestion, carbohy-drates are broken into units of glucose. Glucose enters theblood stream and supplies energy in the brain, organs,and muscles. A child who skips breakfast or doesn’t eatfor several hours will have a lower level of glucose in theblood. This child will feel tired and have trouble concen-trating. Foods rich in carbohydrate supply quick energyby raising the blood’s glucose level.

About half the calories in a balanced diet should comefrom carbohydrate. Food sources of carbohydrate areinexpensive, add variety to the diet, provide quick en-ergy, and may supply other essential nutrients as well.Select carefully the carbohydrate sources in your diet.Whole grain breads and cereals, legumes (beans andpeas), corn, and rice are rich in carbohydrate and alsosupply protein, vitamins, and minerals. Fresh fruits andvegetables supply carbohydrate and are also excellentsources of vitamins. Raw fruits and vegetables, andwhole grain products provide roughage. Roughage, alsocalled fiber, stimulates the intestine walls and helps pre-vent constipation. After a child is old enough to chewwell, raw fruits and vegetables promote healthy gumsand teeth.

Syrup, honey, table sugar, soda pop, and foods madewith a lot of sugar provide empty calories without othernutrients. Limit consumption of these foods, especially inchildren’s diets where sugar may be replacing morenourishing foods. Children who frequently eat sweetfoods may develop unhealthy eating habits which last alifetime. Eating too much sugar causes tooth decay andmay lead to hypoglycemia, diabetes, or obesity. The list“Nutritious snacks for the preschool child” refers tofoods you should emphasize as snacks. The foods listedin “Snacks to be avoided” contain a lot of sugar and afew nutrients.

Nutritious snacks for the preschool child

Dry cereal (not sugarcoated)Hot cerealCrackersRaw vegetablesFresh or canned fruitWhole grain bread or toastBanana breadOatmeal or peanut butter cookiesCheese (cube, slice, or wedge)MilkVegetable juiceUnsweetened fruit juicePeanuts and raisinsHard-cooked eggsPopcorn

Snacks to be avoided

Sugared cerealsCandyHoney and syrupJellies and jamsCookies with icing or fillingCakesDoughnutsRich pastriesSweetened beverages: - carbonated beverages - sweetened fruit drinks - fruit flavored drinks - flavored milks

Vitamins: There are two kinds

More than a dozen vitamins have been identified as es-sential nutrients for the human body. Unlike protein, car-bohydrate, and fat, the vitamins do not provide energy.Each vitamin has a different function in the body. Vita-min A, for example, prevents night blindness and is nec-essary for healthy skin; vitamin D is necessary for strongbones and teeth; vitamin C helps in healing of woundsand resisting infection; and the B vitamins (thiamine, ri-

boflavin, and niacin) help convert food into energy.

There are two types of vitamins, fat soluble and watersoluble. The fat soluble vitamins are carried in the fatportion of foods, and these vitamins can be stored in thebody. Dangerously high levels of vitamins A and D mayaccumulate if you take supplements in excessiveamounts for long periods. Water soluble vitamins arecarried in the water portion of foods and cannot bestored in the body. They are excreted in urine if the bodygets more than it needs. For this reason you should eatgood vitamin B and C sources every day to be sure yourbody has enough.

A deficiency of one or more vitamins can produce a vari-ety of disease-like symptoms, but these are rare unlessthe diet is severely restricted. Many foods common toAmerican diets are enriched or fortified with vitamins.For example, vitamin C is frequently added to fruit juice,vitamin D to milk, vitamin A to butter and margarine,and B vitamins (thiamine, niacin and riboflavin) to flour,rice, cornmeal and cereal products. Vitamin deficienciesand malnutrition occur, but they are rare in this country.Many people, however, suffer from poor nutrition be-cause their diet supplies less than the minimum amountof food necessary for health and growth. Signs of poornutrition in children are described in Section IV.

Vitamins are found in a variety of foods. To supply theessential vitamins, plan a diet including foods from allfour food groups and at least four servings of fruits andvegetables daily. Include one rich vitamin C source dailyand one rich vitamin A source at least every other day.Refer to “Fruits and Vegetables” for a list of good vitaminC and vitamin A sources.

Fruits and Vegetables

Rich sources of vitamin C(Eat one serving daily)

OrangesGrapefruitTangerinesTomatoesJuices or any of the aboveStrawberriesBroccoliBrussels sproutsGreen peppersKale

Rich sources of vitamin A(Eat one serving at least every other day)

BroccoliCarrotsMixed vegetablesPeas and carrotsPumpkinSpinach and other dark green leafy vegetablesSweet potatoesTomatoesSquashApricotsCantaloupePeachesWatermelon

Minerals: Strength and regulation

Your body needs 18 to 20 minerals in tiny amounts toregulate its processes and build its structures. Some min-erals are part of the soft tissues, muscles, nerves, heart,and liver; others build and repair bones and teeth. Miner-als are also found in body fluids and form essential regu-latory substances. For example, iron and copper are partof the red blood cells, and zinc is part of insulin.

Plan the diet carefully to include calcium and phospho-rous, the minerals required in larger amounts by thebody. Calcium and phosphorous work together to buildand maintain strong bones, teeth, and muscles. An ad-equate intake of calcium and phosphorous is especiallyimportant during childhood when bones and teeth aregrowing rapidly. Three or more will provide adequatecalcium and phosphorous. Other good calcium and phos-phorous sources include leafy green vegetables, peas,beans, and sunflower and sesame seeds.

Diets of preschool children frequently lack iron, and thislack can cause anemia. A child with anemia will tire eas-ily, look pale, have frequent infections, and may be un-derweight. Anemia can occur when a preschool childconsumes a lot of milk and few solid foods. The follow-ing list of iron rich foods will help you plan menus forpreschool children. Include a good source of iron in theirdiet very day.

Good sources of iron

Apple juiceBeans, driedBeefCereals, iron fortifiedChickenEggsDried fruit (raisins, prunes, apricots)LentilsNutsPeas (greens, black-eyed)Prune juiceSunflower seedsTomato juiceWhole wheat bread

You can easily get the other minerals your body needs ifyou plan a diet containing whole grain breads and cere-als, milk, meat, peas, beans, and vegetables. You may begetting more sodium in your diet than you need. Mostprepared foods and snack foods contain a lot of sodiumin the form of salt. Too much sodium over a long periodcan cause high blood pressure and lead to a stroke orheart attack. Eat less salt by eliminating salty food, re-ducing salt added during cooking, and omitting salt atthe table.

Water: Essential and calorie free

Although water is not usually considered a food, it’s anessential nutrient. Humans can survive longer withoutfood than without water. Water is a part of every cell,tissue, and metabolic process. It carries nutrients to thecells and waste products from the cells. Water is themajor component of blood and helps regulate bodytemperature.

Water comes from the obvious sources-drinking water,coffee, tea, fruit juices, milk, and other beverages. Wateris also in every food you eat. Some fruits and vegetablescontain more than 80 percent water. Because water pro-vides no calories, fruits and vegetables containinga lot of water, such as lettuce, celery, and apples, are lowin calories.

Preschool children should drink four to five glasses offluid each day. Thirst is the best indicator of the need forwater, but children often need to be reminded. Offerwater to children several times a day. It won’t spoil theirappetites and it helps them develop the habit of choosingwater instead of high-calorie, low-nutrient beverages.Fruit juice and milk are the best drinks to offer childrenat meals and snack time because these drinks quenchthirst and provide nutrients.

Poor Nutrition In Children:Symptoms To Look For

Symptoms of severe nutritional deficiency, or malnutri-tion, are rarely seen in this country, but less obvious signsof poor health caused by poor nutrition may appear.During a child’s period of rapid growth, from birth to 5years, poor nutrition can affect physical growth andmental development. Physicians are trained to recognizemalnutrition, but children are usually examined onlyonce a year or during illness, so symptoms of poor nutri-tion may not be noticed. As a care giver you should befamiliar with the symptoms of a poorly nourished child.A list of nutrition related symptoms is provided for youruse. If you observe a child with one or more of thesesymptoms, talk with the child’s parents or guardians.The child may not be getting enough food, or may re-

quire a physician’s attention. In infants, the signs of mal-nutrition may be subtle. An infant receiving enough fluidwill have six or more wet diapers each day. The bowelhabits of a healthy infant range from several small move-ments each day, to one every other day. Suspect diarrheawhen the diaper is filled four or more times a day, andreport your suspicions to the parents. Notify a physicianif this condition persists for more than 24 hours, becausedehydration can occur rapidly.

A gradual weight increase is probably the best indicatorof good nutrition in an infant. Most infants will doubletheir birth weight in five months and triple their birthweight in the first year. The next page is a chart of signsof poor nutrition in a preschool child.

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How Much Is Enough?Nutritional Requirements Of Children

Care givers are faced with a challenge: feeding youngchildren who have small and erratic appetites. This prob-lem is complicated because children require nutrients inalmost the same quantities as adults, but they need fewercalories. If children are to consume adequate vitamins,minerals, and protein, their diets must be carefullyplanned. Offer children only the most nutritious foods atmeals and snack time. Avoid food that provides calorieswithout many nutrients. Scientists identify more than 50nutrients that must be included in the diet, but planninga diet to include all 50 is a difficult task. To simplify

menu planning, nutritionists have designated leader nu-trients. Certain food groups supply certain leader nutri-ents. Refer to the following list of the four basic foodgroups and the leader nutrients supplied by each.

If you plan diets to include the leader nutrients, then theother essential nutrients usually will be included. It isimportant to note that you can plan an adequate diet us-ing the four basic food groups only if you include a vari-ety of food in the menu.

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