FSHN 322 Group Program Planning Assignment November 15, 2013

Student Name Courtney Marques Signature Role in program development Create Coversheet Conduct needs assessment/literature review Marketing Plan (flyer) Program Name Conduct needs assessment/literature review Marketing plan (where/how to market) Curriculum-lesson plans Educational Materials Curriculum-lesson plans Educational Materials

Urvi Shah

Tiffany Kosanda Angela Jose

Program Name:

Kids in the Kitchen - Getting your preschooler involved in Nutrition!

Target Audience:

Nutrition class for parents and their children to learn about target nutrients, discuss healthy eating habits, and get kids involved in their food choices. Participants will be recruited from the ChampaignUrbana area to attend the program at the Champaign Park District.

Literature review and Community needs assessment Preschool age, from three to five years of age, is a critical time in growth, learning and development. At this age children are learning to explore their environment

in new ways, becoming more independent, spending time away from home, and forming new social bonds. Preschoolers are also developing language and behavior control during this time. 1 Although growth has slowed somewhat since toddlerhood and infancy, the importance of adequate nutrition has not diminished. Children in this age group need the right amount and type of fuel to ensure healthy growth in such a significant time of cognitive maturation. This is also an important time for laying the foundation for healthy eating habits later in life. Modeling good nutrition habits and teaching children how to attend to their bodys hunger and satiety signals are valuable lessons that parents should focus on during this time. These lessons can often be difficult for parents to teach because of the unique nutritional challenges that preschool age children often present. Knowing how much to feed children of this age can be tricky as well as dealing with picky eating tendencies, food jags, and different temperament styles. It is important to understand how these tendencies affect specific nutrient and supplement needs of this population. Due to these characteristic problems associated with this age group nutritional resources have been developed to help parents navigate these turbulent waters. The parents of preschool age children in Champaign-Urbana have several options in seeking advice and support. It is our hope that by defining the needs, habits, concerns, and resources available for this population we can fill in the gaps to ensure that parents are well informed of the nutritional needs of their children during this critical time in development. Preschool age is a time of slowed growth and continued cognitive development. It is important that nutritional needs be met to ensure healthy brain and muscle growth. With sporadic eating behaviors and fluctuating appetite parents need to be attentive to make sure that their child is getting adequate nutrients. Parents can only be as effective as their own knowledge on the subject of preschool nutrition. In a study conducted by Kent State University, parents nutrition knowledge affected what they packed their preschoolers for lunch. The study concluded that parents with greater knowledge packed more whole grains, meat, and beans. Overall, the lunches were found not to meet the nutrition standards set by the USDA.6 In another study, nutrient intakes of US infants, toddlers, and preschoolers were studied to see if they met or exceeded the Dietary Reference Intakes. In preschoolers, energy requirements were usually met or exceeded. Vitamin E and Potassium were of concern for this age group. Also, adequate fiber was not present in most diets.7 The American Dietetic Association (ADA) recommends that children consume between 1200 and 1400 calories per day to meet their needs depending on gender.3 In addition to energy, certain nutrients should be of particular concern, especial iron, calcium and zinc. Deficiency of any of these micronutrients can be prevented with a balanced diet that includes a variety of foods. Encouraging consumption of a variety of fruits vegetables paired with high quality protein and whole grains is typically adequate to meet most needs. Meeting the requirement of these often scarce nutrients can be accomplished with few additions.

Low fat dairy and enriched products, such as orange juice with calcium, can aid in meeting childrens calcium needs. Calcium is important for ensuring the strength of bones as the child grows. Zinc and iron needs can be met with high quality lean protein. It is important to note, however that, iron deficiency anemia is very prevalent in children in this age group in the United States.1 Our main sources of iron typically align with our main sources of protein and while the American diet generally provides more protein than is needed, it is the type of protein being consumed that becomes the concern. Meats and beans are good sources of iron and if possible should be paired with fruits and vegetables that contain vitamin C to improve absorption. As stated, most children will not need supplements with a varied diet. However, there are some groups that should consider taking supplements. These groups include children from deprived families, children with poor appetite, children who consume only a few types of food and especially vegetarians without dairy products.1 A doctor or registered dietician should be consulted in these conditions. Keeping these things in mind will ensure that children of this age group will get the nutrients they need and the ones that may be scarce in a typical diet. Another growing concern with this population is sugar and sugar sweetened beverage consumption. These trends in preschoolers diet contribute to two other major concerns, dental caries and childhood obesity. Dental caries are fairly prevalent in children between three and five years of age, approximately one third have them.1Parents should be aware of the importance of good dental hygiene habits. Carbohydrates, including sugar, are the main source of energy for the bacterium Streptococcus mutans, the main cause of tooth decay, so placing some limit on these foods helps in prevention of dental caries. 1 Limits on these nutrients may also play a role in obesity prevention in this age group. The ADA has identified this age group as being ideal candidates for obesity prevention initiatives. Many interventions have been proposed, however, most focus on physical activity and consumption of fruits and vegetables2. The ADA proposed the stoplight diet to help teach children about green light foods that are nutrient dense and low calorie, yellow light foods that have moderate calorie density and moderate nutrients, and red light foods that are high in calories and low in nutrients2. These guidelines serve as a starting point for parents to begin teaching their children about healthy versus not healthy foods without imposing too much restriction. In addition to monitoring what this age group is eating parents have to combat eating behaviors that, at times, go against healthy eating behaviors. As children explore their autonomy at this age it is important to provide a good example for them to follow. Preschool children develop important feeding skills that expand their diet options. They are able to use utensils with more dexterity and also drink from a cup.1This time is also a good time to introduce new foods although this may be challenging. Picky eating is a common problem in this age group but there are ways to combat it. Preschool age children are able to help prepare the meals that they will

eat, which will encourage receptivity to new foods. Acceptance of new foods takes time and several introductions which require patience on the part of parents. It is easy to get frustrated and give in to the childs demands. A food may take as many as 8 -10 introductions to be accepted by a child. Food jags are common as well but children should be offered the same food as the rest of the family. Making separate meals for a picky eater is discouraged because this promotes the behavior. Additionally, parents may be tempted to place restrictions on less nutrient dense foods that children are exposed to in their environment, especially through media. A critical part of this is allowing the child to be attentive to satiety cues and hunger signals.1 This is the time when parents should give some feeding responsibility to the child by allowing them to decide how much they want to eat and when. Understanding that children actually pay attention to their hunger and satiety cues much more closely than most adults do. While there are many factors that contribute to obesity in children and adults, a huge step in prevention is teaching children how to feed their bodies not their cravings. In the Champaign-Urbana area alone, there are multiple programs that are available to increase nutrition and knowledge for this population. A well known program is the Woman, Infants, and Children (WIC) program. This is a federal government program available to pregnant, postpartum, and breastfeeding women, infants, and children up to age 5. The WIC program is available to individuals that are determined by state standards to be at nutritional risk.4 There are many benefits to the WIC program. Some of the benefits include food vouchers, blood tests, nutrition counseling, and more. Some local schools are also taking an active stance on educating children about healthy living. La Petite Academy in Champaign has a program called Grow Fit that focuses on physical activity, limited screen time, nutritious foods, and water as a primary beverage.5 In addition to the programs in the Champaign-Urbana area, there are many good resources that can be utilized. Some reputable websites include ChooseMyplate.gov and HealthyChildren.org. In Conclusion, during this critical period for growth and development, it is important for parents to be knowledgeable about proper nutrition for preschoolers. Preschoolers are physically and mentally growing during this time. Adequate nutrition contributes to both types of growth. In addition, during this time period, children will develop eating habits for the rest of their lives. Parents should model good behaviors for their children. Also, having a varied diet, being physically active and being involved are all important for children at this age. Parents can teach their kids proper nutrition that will stay with them for the remainder of their lives.

References: 1. Brown, Judith E.. Nutrition through the Life Cycle, Fifth Edition. Stamford, CT: Cengage Learning; 2014, 2011.

2. American Dietetic Association. Position of the American Dietetic association: Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity. J Am Diet Assoc. 2013; 113(10):1375-1394. 3. American Dietetic Association. Position of the American Dietetic association: Guidance for Healthy Children Ages 2 to 11 Years. J Am Diet Assoc. 2008; 108(6):1038-1047. 4. Women, Infants, and Children FAQ. U.S. Department of Agriculture Website. http://www.fns.usda.gov/wic/faqs/faq.htm. Published June 25, 2013. Accessed November 12, 2013. 5. Grow Fit: Building Healthy Habits for a Healthy Future. La Petite Academy Website. http://www.lapetite.com/our-schools/champaign-il-7010/nutrition/. Published 2013. Accessed November 12, 2013 6. E. Buchanan, N. Caine-Bish, K. Lowry Gordon, N. Burzminski, Nutrition knowledge of parents and the packed lunch items in their preschooler's lunches. J Nutr Educ Behav. 2012; 44(4): 55. 7. Nancy F. Butte, Mary Kay Fox, Ronette R. Briefel, Anna Maria Siega-Riz, Johanna T. Dwyer, Denise M. Deming, Kathleen C. Reidy. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. J Am Diet Assoc. 2012; 100(12): 27-37.

Marketing/Promotion - Social Media Plan There are many ways to market and promote this program to the ChampaignUrbana community. Because we intend this program to take place at the Champaign Park District, this will be the main outlet we will use to market. Posting the program on the Champaign Park District website, in their program directory, and on their facebook page will be vital. By doing this, the current patrons of the park district will be reached. In addition to this, we will post fliers in clinics, in the park district, and around the community in local businesses. We can also submit a brief ad to the community TV channel and in the MTD buses. Through these diverse outlets, we will be able to reach a large number of people to consider our program. Using social media, such as facebook, is important to reach a wide variety of people. Social media is an outlet that has become as prevalent in some peoples lives as the news is to others. Program Synopsis Our program is directed mostly to the parents of preschoolers, but we will have them bring their kids for the last two sessions. Our goals are to teach parents appropriate foods and amounts to serve at meals as well as teach them how to introduce new foods to their child.

Lesson 1: Basic Nutrition/MyPlate 1. Length: 30 minutes 2. Agenda a. Learning Objective: i. Introduce parents to MyPlate and what entails a healthy diet ii. Discuss potential need for multi-vitamins or supplements based on different nutrient requirements-frequently not necessary b. Learning Activity: i. Showcase MyPlate Website. Show them things like supertracker, Daily food plans, and physical activity tools. This can be used to determine how balanced their diet is and of their children, and get ideas for balanced diets/ meal plans for their kids. (15 minutes) ii. Show http://fnic.nal.usda.gov/fnic/interactiveDRI/ to find nutrient requirements for child. This will allow parents to have a better idea of their childs recommended intake; at the very least they should be able to check recommended amounts of macronutrients. A few examples would be shown so parents could get a rough idea of their childs energy requirements (5-8 minutes).

iii. Discuss dietary supplements and answer question about supplements. Supplements may not be necessary if child gets regular balanced meals and snacks. Vitamins and supplements suggested for irregular or picky eaters, and vegetarian diets. If they want to supply a supplement they should be aware of the fact that gummy vitamins typically lack iron a very common deficiency especially in vegetarian diets (7-10 minutes) 3. Educational Material a. Getting Started with MyPlate b. Be a Healthy Role Model for Your Kids

Lesson 2: Portion Size 1. Length: 35 min 2. Agenda c. Learning Objective: i. Teach appropriate serving sizes for children, for instance 1 tbsp per year of age is adequate portion size. ii. Learn how to visually measure amount of food, for instance a 3oz serving of meat is about the size of a deck of cards. d. Learning Activity: i. Portion Distortion Game (Considers adult portions). http://hp2010.nhlbihin.net/portion/portion2.cgi?action=question&nu mber=1. This will show how portion sizes have changed over time, and show the parents how much they may be over eating, so they can be aware of it and avoid it in their kids. (10 minutes) ii. Showcase proper portion sizes with examples. Discuss proper portion sizes. A serving size is about a tablespoon per year of age as a toddler. Then show ways to determine serving size, like a deck of cards for 3 oz. of meet, or a tennis ball for a serving of fruit. Remind them that because children are smaller, the portions should be smaller; suggest using their hand to determine serving size. As an example a serving of meat should be about the size of the childs fist. (10 minutes) iii. Have parents go around the room looking at real food, determining proper portion size at some stations, while others show measuring spoons or play food to show appropriate portion size. Other stations may have a variety of plates, and bowls, and the parents can see how much each dish holds. (15 minutes) 3. Educational Material a. Portion Size Handout b. Hand Portion Handout

Lesson 3: HOW TO DEAL WITH PICKY- EATERS 1) Length of Session: 45 minutes 2) Agenda a) Learning Objectives i) Ensure that children who are picky eaters maintain a good nutritional status. ii) Help child become more accepting of different food options that they normally would not eat. b) Learning Activities i) Mealtime Schedule (15 minutes) (1) Children thrive on a routine. Having a set time where the whole family can sit down and enjoy a meal together can encourage the child to sit and eat the food provided for them, especially if parents and older siblings are eating the same things. During this activity the parents will plan out a mealtime schedule for their child including snack times. ii) Fun with Food (30 minutes) (1) Kids love food that come in fun shapes, sizes, colors, etc. To make eating more interesting try using cookie cutters to cut food into fun shapes. Offering dipping sauces for vegetables like broccoli and carrots will make them more appealing and encourage kids to eat them. For example, celery is usually not a favorite snack for kids but if you use celery and create Ants on a Log they will be more likely to enjoy it. For this activity we will provide the parents with cookie cutters, fun containers, and other materials to make food look more fun. Then we will bring the kids in so that parents can see how the children react to the new food options.

Lesson 4: ENGAGE YOUR CHILD IN MEAL PREPARATION 1) Length of Session: 60 minutes 2) Agenda a) Learning Objectives i) Effectively include child in the meal preparation step. ii) Increase childs likelihood to eat healthy food which they normally would not find appealing. b) Learning Activities i) Family Fun (30 minutes) (1) Children are more likely to eat food that he or she selected from the store. In order to use this to a parents advantage, they should incorporate children into the grocery shopping experience. For this activity we will bring the children in and have a small shop set up in the room. The parents will narrow down the options to a few healthy options then they ask the child for help in buying groceries from the predetermined options. ii) Cooking with the Kiddos (30 minutes) (1) Involving kids in the cooking will really increase their likelihood to eat the food that you make. For this activity we will incorporate the kids again. Parents can have the kids help them prepare food like PB&J sandwiches, pick off grapes from the stem, and peel oranges.

Picky Eating (from ChooseMyPlate.gov) Do any of the statements below remind you of your preschooler?

"Michael won't eat anything green, just because of the color." "Ebony will only eat peanut butter sandwiches!" "Jacob won't eat peaches because they are 'hairy' or pears because they are 'scratchy.'" "Maria doesn't sit still at the table. She can't seem to pay attention long enough to eat a meal!" "Bananas used to be Matt's favorite food, now he won't even touch them!" "Emily will eat any foodas long as it's white. White potatoes, white bread, white beans. It just has to be white. At least she drinks her milk!" You are not alone. Picky eating is a typical behavior for many preschoolers. It is simply another step in the process of growing up and becoming independent. As long as your preschooler is healthy, growing normally, and has plenty of energy, he or she is most likely getting needed nutrients. If you are concerned that your child's picky eating has lasted for a long time or is very restrictive, speak with your child's doctor.

What are some common types of picky eating? Children often want to explore food rather than eat it. Many children will show one or more of the following behaviors during the preschool years. In most cases, these will go away with time.

Your child may be unwilling to try new foods, especially fruits and vegetables. It is normal for your preschooler to prefer familiar foods and be afraid to try new things. a period of time, your preschooler may only eat a certain type of food. Your child may choose 1 or 2 foods he or she likes and refuse to eat anything else. your child may waste time at the table and seem interested in doing anything but eating. child may refuse a food based on a certain color or texture. For example, he or she could refuse foods that are red or green, contain seeds, or are squishy.

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What can you do to cope with your preschooler's picky eating? If you dont make it a big deal, it will usually end before school age. You can do many positive things to deal with picky eating and help your child learn to try new foods.

Let your kids be produce pickers. Let them help pick out fruits and veggies at the store. Kids like to try foods they help make. It's a great idea for helping your picky eater try fruits and vegetables. Children also learn about fruits and vegetables when they help make them. And all of that mixing, mashing and measuring makes them want to taste what they are making. See a list of kitchen activities that your child can do. Try to make meals a stress-free time. Talk about fun and happy things. If arguments often happen at mealtimes, your preschooler may learn unhealthy attitudes toward food. Offer choices. Rather than asking "Do you want broccoli for dinner?" ask Which would you like for dinner: broccoli or cauliflower? Offer a variety of foods and let your child choose how much of these foods to eat. Tips on helping your child recognize how much to eat. Offer the same foods for the whole family. Don't be a short-order cook, making a different meal for your preschooler. Your child will be okay even if they don't eat a meal now and then. Make food fun! Get creative in the kitchen with these cool ideas. A child that helps in the kitchen: Tries and likes more foods Gains confidence, feels important, and proud Learns early math and science concepts Learns new vocabulary Develops small muscle skills Learns responsibility with cleanup

What can you do to get your preschooler to try new foods? It is completely normal for young kids to reject foods they have never tried before. Here are some tips on how to get your preschooler to try new foods:

Sometimes, new foods take time. Kids don't always take to new foods right away. Offer new foods many times. It may take up to a dozen tries for a child to accept a new food. Small portions, big benefits. Let your kids try small portions of new foods that you enjoy. Give them a small taste at first and be patient with them. When they develop a taste for many types of foods, it's easier to plan family meals.

Be a good role model by trying new foods yourself. Describe its taste, texture, and smell. Offer only one new food at a time. Serve something that you know your child likes along with the new food. Offering too many new foods all at once could be overwhelming. Offer new foods first, at the beginning of a meal, when your child is the most hungry. Serve food plain if that is important to your preschooler. For example, instead of a macaroni casserole, try meatballs, pasta, and a vegetable. Also, to keep the different foods separate, try plates with sections. For some kids the opposite works and serving a new food mixed in with a familiar item is helpful.

Involving Children in Food Preparation Every Day! Samantha Ramsay, PhD, RD, LD, Laurel Branen, PhD, RD, LD, Rosario Wohlsen, Janice Fletcher, EdD
Objectives: Keep children involved, busy, and safe. Get meal done. Maintain routines. Boost childrens self-esteem. Encourage healthy eating habits.

Step I - Choose a task for your child Choose tasks that are simple and that require little or no supervision. If you feel confident that your child has performed a more complicated task successfully before and can do it again without effort, you may assign him/her a more complicated task. Give each child a task according to his/her skill level, all children need to be involved to their own ability ( Your two year old may be able to tear lettuce but not to wash it; your four year old may be able to wash a potato but not yet to peel it) Examples: Bringing dry ingredients to table: bread, fruit, and/or vegetables for salad, etc. Wash fruit in the sink Tear lettuce for salad Set the table for the family Spread mayonnaise or peanut butter for sandwiches

Step II - Explain to your child what you want to do and how she/he will help. You can tell your child that you need to make dinner fast for all the family, tell him exactly what he/she will do, and that you both will need to work together so everybody can eat and then have time for other fun things to do together. Step III - Wash hands Wash your hands in front of your child and help him/her wash too. (Correct hand washing procedure: water, soap, scrub for 20 seconds, dry, turn faucet off with paper towel). Step IV - Demonstrate Show your child how to do the task you chose for him by doing it slowly in front of him/her while describing what you are doing. Give one direction at a time. Start the task off so he/she can see it and listen to directions, then let him do it by him/her self. Step V - Trust Trust that your child is capable of doing the task you gave him/her. Allow him/her enough time to do it, and remember it does not need to be perfect! Step VI - Appreciate

Make sure to acknowledge your childs efforts and let him/her know his/her work was very appreciated and needed for the whole familys benefit. Show that you enjoy the meal you prepared together.