spicing up healthy snacks for better health
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Spicing Up Healthy Snacks for Better Health. Craig A. Johnston, Ph.D. Jennette L. Palcic, Ph.D. Baylor College of Medicine Department of Pediatrics-Nutrition Children’s Nutrition Research Center. Calories From Snacks Are Up. A Major Shift: Steady increase over the last 3 decades - PowerPoint PPT PresentationTRANSCRIPT
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Spicing Up Healthy Snacks for Better Health
Craig A. Johnston, Ph.D.Jennette L. Palcic, Ph.D.
Baylor College of MedicineDepartment of Pediatrics-Nutrition
Children’s Nutrition Research Center
Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. www.schoolnutrition.org
Calories From Snacks Are Up
A Major Shift:•Steady increase over the last 3 decades
Approximately 100% increase in # of snacksAlmost 3 snacks per day
•Prevalence of “snackers” increasesFrom 48% to 78%
• More calories are coming from snacksUp to 27% of caloric intake
Source: Piernas & Popkin, 2010; Health Aff
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Prevalence of Overweight & Obesity in Children (Ages 6-11)
• 36.5% At risk of Overweight or Overweight• 19.9% Overweight• Obesity has quadrupled over 25 years • African American, Hispanic American & Native
American children have highest obesity prevalence
Source: Ogden et al., JAMA, 2006
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Mixed Findings
• No association between meal patterns and overweight status
• Snacking frequency positively associated with rates of obesity
• Overall, it is unclear the role that snacking plays.
Source: Nicklas et al, 2003; Am J Prev MedKerr et al, 2009: Br J Nutr
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Elana’s study
• The Following are slides that we received from Elana- Will need to be only shown on presentation day.
Source: NFCS, 1977-78; CSFII 1994-98; WWEIA, NHANES 2005-06, 1 day, 9-12 year olds
Number of Eating Occasions in a Day
3.9 4.85.8
0
2
4
6
8
10
Percent
1977-78 1994-98 2005-06
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75
49
20 23
39
52
210
22
0 27
0
20
40
60
80
Percent
2-4 5-6 7-8 9+Number of eating occasions
1977-78 1994-98 2005-06
Frequency of Eating Occasions
Source: NFCS, 1977-78; CSFII 1994-98; WWEIA, NHANES 2005-06, 1 day, 9-12 year olds
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Percent Reporting Meals1977-78
2005-06
Difference
Breakfast
93
84
-- 99
Lunch
85
85
Dinner
96
96
S
nacks
63
98
+35
Ate breakfast, lunch, and dinner . . . 77 70 - 7
Source: NFCS 1977-78; WWEIA, NHANES 2005-06; 1 day; 9-12 year olds
37
17
2
55 57
39
8
20
41
0
6
18
0
20
40
60
80
Percent
0 1-2 3-4 5+
Number of snacking occasions
1977-78 1994-98 2005-06
x = 3
Source: NFCS, 1977-78; CSFII 1994-98; WWEIA, NHANES 2005-06, 1 day, 9-12 year olds
Frequency of Snacking
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Top 10 Foods Reported as Snacksby 9-12 year-old children
BeveragesSavory snacks from grainsCandy
FruitsCookies & barsIce cream
Potato chips & French friesCakes, doughnuts, pastries, piesPizza, burritos, tacos
Sandwiches
soft drinksfruit drinksmilkfruit juices
popcorntortilla chipspretzelscrackers
applesbananasgrapesoranges
chocolate chip cookiescrème-filled choc. cookiessugar cookiesbrownies
Source: WWEIA, NHANES 2005-06, 1 day, 9-12 year olds
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Characteristics of Our Sample
• 6.5 eating episodes observed daily2.5 of these explained by meals
• No difference in eating episodes based on weight status
• No association between BMI percentile and number of eating episodes
• Upon visual inspectionInformation obtained from a “backpack raid”
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Snack Intervention Substitution of nutritious snack foodsBackpack Raid 1 oz portion of peanuts or ¾
oz PB given daily at school
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What We Know:• US children have
inadequate intake of micronutrients (less than RDA)
• Mexican American children have been shown to have the most nutritionally deficient diets
• Obesity is increasingly becoming associated with poor nutrition = “Malnourished Obese”
Nutrient Adequacy
May 2008
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Our Approach: Positive Messaging• Family Focused• A message for everyone• Find foods that are:
Closer in value to preferred foodsReadily acceptableNot perceived as “diet food”Healthy for all children
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FLOW Methods and Main GoalsIntensive Intervention (II)
• Received a book
• Spends “intervention time” in study hall/health class
• Daily contact (Mon- Fri)
• 1 weekly nutrition education session
• 4 weekly physical activity sessions • A daily snack intervention at school of 1 oz peanuts or ¾ oz peanut butter
• A way to improve eating patterns- Skipping/Adding meals- Reduce hunger
• Improve snacking habits- Nutrient-rich for nutrient-poor- Proper portion- Satiety- Combination foods
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Better Weights at 2 Years in Treatment
1.2
1.3
1.4
1.5
1.6
1.7
1.8
Baseline 1 year 2 years
zBMI
SH ILI
Treatment
Control
Maintenance Effects:Change in BMI over time, 2 years; Cohorts 1+2
Remains above baseline
SIGNIFICANT
Source: Johnston et al., 2010; Obesity
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79.5
35.5
62.1
35.3
20.5
64.5
37.9
64.7
0
10
20
30
40
50
60
70
80
90
100
Percentage
zBMI decrease ormaintenancezBMI increase
ILIILI SH SHBaseline to 1 Baseline to 2 years
Source: Johnston et al., 2010; Obesity
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Important Biomarkers• Improved Lipids
– Total cholesterol– “Bad” LDL cholesterol– Triglycerides - trending down
• Improved Anthropometrics – ie. smaller waists
• Improved Quality of Life
hsC-RP
Inflammatory Markers
BASELINE
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Spicing up Nutrition Education
Jennette Palcic, PhD
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Nutrition Education Simple and Positive
• Categorizing foods− big bite− little bite− portion right
• Satiety− Choosing “filling options”− Determining when you have had “enough”− Addressing adolescent dietary habits (ie. Eating patterns, meal skipping, snack choices)
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Peanut Eaters Have Better Bodies and Better DietsRATIONALE for peanut snack intervention
WE SAW AT BASELINE:•Inflammatory markers higher in at risk and overweight children •Peanut eaters less likely to be overweight•Peanut eaters had better nutritional profile
Normal Weight OverweightPeanut or PB 60% 40%
NO peanut or PB 36% 64%
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Hunger Significantly Decreased after Snack Intervention
Hunger ratingsM p
Baseline 5.723 months 4.63 .0016 months 4.60 .01
Probable explanations:–Nutrient dense–Satiating–Acceptable–Affordable
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Healthy SnackingWe’ve also learned how to get kids to eat vegetables
At baseline the majority
ate veggies “zero” days per
week
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Eat Your Vegetables!
• Randomized children to – Regular Exposure– Pairing with peanut butter
• Significant differences at 3 months– Pairing group ate more (oz)– Pairing group ate a greater variety
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Cooking with Kids
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Recipe Ideas
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Other Benefits
• Kids excited about trying new foods• A hands-on approach helps• Shift from
– These are the foods you need to stop eating• Moving towards
– These are the foods (that you like) you need to start eating
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The Motto of YES Charter Schools
WHATEVERIT
TAKES!
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“The Current Epidemics of Chronic Diseases are a Result of Discordance Between Our
Ancient Genes and Modern Lifestyle.”
Eaton et al., The Paleolithic Prescription. 1988.
Nature vs. Nurture