'EMPOWER'ing Healthy Youth in Early Care and Education

Adrienne Z. Udarbe, MS, RD

Arizona Department of Health Services

Bureau of Nutrition and Physical Activity

Overview

• Why Focus on Childcare/Early Care and Education?• Current Initiatives• Arizona Guiding Principles for Childcare Nutrition• Beyond The Plate…The Nutrition Environment in

Childcare• Physical Activity• Opportunities

“The risk of obesity starts early in life. Over half of obese children become overweight by the age of 2, and approximately one in five children are overweight or obese by their 6th birthday.”

— The White House Task Force on Childhood Obesity

Scope of the Problem in AZPercentage of Obese Children in

Arizona (Ages 2-5) *PEDNSS

Year Arizona

2004 12.4%

2005 12.8%

2006 13.5%

2007 14.4%

2008 14.6%

Why Prevention in Early Care and Education?

• School and early care environments are key for cultivating healthy habits at an early age.

• Teachers and caregivers are in a special position and uniquely qualified to help children establish positive healthy lives early for later success.

We Are All In This Together

• No fix-it-all approach

• Food environments

• Built environments

• Families, caregivers, teachers, doctors all working together

So What is Empower?Childcare providers implement 10 nutrition, physical activity, and tobacco prevention practices to become “Empower” centers in exchange for licensure fee reduction.

10 Ways to Empower Children to Lead Healthy Lives

1) Provide at least 60 minutes of structured activity and at least 60 minutes and up to several hours of unstructured physical activity each day

2) Limit screen time to under one hour a day

3) Avoid more than 60 minutes of sedentary activity at a time, except while the child is sleeping

4) Serve meals family style by letting the child decide how much to eat and avoid using food to reward behavior or for a clean plate

5) Provide families education and referrals regarding tobacco prevention cessation and second hand smoke

6) Serve one percent low fat or fat free milk for all children over two years

7) Offer water at least four times during the day (water is not to be served during lunch)

8) Limit juice to 100 percent fruit juice (with no added sugars) and to no more than 4-6 ounces/day.

9) Enforce 24 hour smoke-free campuses (no smoking 20 feet from any entrance)

10) If eligible, participate in the USDA Child and Adult Care Food Program.

10 Ways to Empower Children to Lead Healthy Lives, cont.

Regardless of structure, location, and resources, all early care and education programs have opportunities to incorporate elements into their program that will encourage youth to be healthy.

Talking About Health So Children Will Listen

• Inappropriate to label children as "obese”

• Youth do not always understand what it means to be obese

• Respond better to messages that encourage "activity" rather than “exercise”

• Youth also define being a healthy weight by being comfortable with their bodies and having self-confidence.

Parents As Partners

Involve parents in activities designed to promote good dietary and exercise habits in order to reinforce healthy behaviors at home.

Avengers Assemble!

Merging Forces To Build A Better Plate.

Arizona Child Care Center Rules and CACFP Meal Patterns

• Nutrition Licensing Rules for Centers– Article 5

• The Child and Adult Care Food Program– CACFP

CACFP Requirements • Breakfast must include a milk component, a grain component, and a

fruit or vegetable component.• Lunch/Supper must include a milk component, a grain component, a

meat or meat alternate component, and a fruit and vegetable component from two different sources.

• Snacks must include two of the following four components: milk, grain, meat or meal alternate, and fruit or vegetable.

• High sugars (>35% total sugar by weight) must be limited to two times per week and may only be served at breakfast and/or snack time. High fat (>35% total calories) items must be limited to two times per week.

Food Components(1-12 Year olds)

Ages 1-2 Ages 3-5 Ages 6-12

Breakfast

Milk, fluid

Vegetable, fruit, or 100% juice

Grains/bread (whole grain or enriched)

or cornbread, rolls, muffins, or biscuits

or cold dry cereal or cooked cereal, pasta

noodle products, or cereal grains

½ cup

¼ cup

½ slice

½ serving

¼ cup or 1/3 oz¼ cup

¾ cup

½ cup

½ slice

½ serving

1/3 cup or ½ oz¼ cup

1 cup

½ cup

1 slice

1 serving

½ cup½ cup

Food Components Ages 1-2 Ages 3-5 Ages 6-12

Lunch or Supper

Milk, fluid

Vegetable and/or fruit, or 100% juice

Grains/bread (whole grain or enriched) or cornbread, rolls, or biscuits or cooked cereal, pasta, noodle products, or

cereal grains

Meat or meat alternates Lean meat, fish or poultry or cheese or cottage cheese, cheese spread, cheese

food or egg or cooked dry beans or peas or yogurt (low or nonfat) or peanut butter, soy nut butter or other nut

or seed butters or peanuts, soy nuts, tree nuts or seeds or an equivalent quantity of any

combination of the above meat/meat alternates

½ cup

¼ cup total

½ slice½ serving¼ cup

1 ounce1 ounce2 ounces or ¼ cup1 egg¼ cup½ cup2 Tbsp

½ ounce1 ounce

¾ cup

½ cup total

½ slice½ serving¼ cup

1-1/2 ounce1-1 1/2 ounce3 ounces or 3/8 c1 egg3/8 cup¾ cup3 Tbsp

¾ ounce1-1 1/2 ounces

1 cup

¾ cup total

1 slice½ serving½ cup

2 ounces1-1 1/2 ounces4 ounces or ½ cup1 egg½ cup1 cup4 Tbsp

1 ounce2 ounces

Food Components Ages 1-2 Ages 3-5 Ages 6-12

Snack (select 2 of the 4 components)

Milk, fluid

Vegetable, fruit or 100% juice

Grains/breads (whole grain or enriched) Bread or cornbread, rolls, muffins, or biscuits or cold dry cereal or cooked cereal, pasta, noodle products, or cereal grains

Meat or meat alternates Lean meat, fish or poultry or cheese or egg or yogurt or cooked dry beans or peas or peanut butter, soy nut butter or other nut or seed butters or peanuts, soy nuts, tree nuts or seeds or an equivalent quantity of any combination of the above meat/meat alternates

½ cup

½ cup

½ slice½ serving¼ cup or 1/3 oz¼ cup

½ ounce½ ounce½ egg or ¼ cup1/8 cup

1 tablespoon½ ounce½ ounce

½ cup

½ cup

½ slice½ serving1/3 cup or ½ oz¼ cup

½ ounce½ ounce½ egg or ¼ cup1/8 cup

1 tablespoon½ ounce½ ounce

1 cup

¾ cup

1 slice1 serving¾ cup or 1 oz½ cup

1 ounce1 ounce1 egg or ½ cup¼ cup

2 tablespoons1 ounce1 ounce

Why Nutrition Policies?• Policies support and sustain the

changes/standards you want in your center• Create consistent messaging for children,

staff, and parents• Guides classroom decisions• Prevents problems and provides solutions

What About Infants?• Communicate with parents

when/how to introduce solids• AAP strongly recommends

waiting until 6 months• Provide a

comfortable/supportive environment for breastfeeding

The Environment…Supporting Healthy Relationships With Foods

• Positive

• Cheerful

• Relaxing

• Predictable Routines

Hungry or Full

• Teach children how to recognize when hungry or full: – Ask if the child’s tummy is hungry when he or

she wants to eat – Ask the child to touch its tummy to show

where hunger or fullness is felt – Ask if the child’s tummy is full at the end of a

meal

Hungry or Full, continued

• Children should be reminded to chew food completely. Their bodies need time to realize they have had enough to eat

• Let children learn to listen to their internal hunger cues. Do not require a clean plate, and allow seconds if desired.

“Choosy” Eaters

• Encourage, but do not force, children to try and taste new foods

• Do not just offer “typical” child foods

• Have a taste-test when introducing a new food. Then have children vote yes or no

• Try to avoid mealtime power struggles

Foods Brought From Home

When foods are provided from home, families must provide meals that meet the USDA CACFP Meal Pattern. Foods provided by parents are healthy choices of grains and breads, meat and meat alternates and fruits and vegetables. They are low in fat, added sugars and sodium.

Celebrations• A healthy nutrition

environment is created by serving nutritious foods during regular meals and snacks as well as at special occasions.

• Celebrate holidays or special occasions with mostly healthy foods and non-food items.

Staff and Workplace Wellness

When staff members improve their own personal health and wellness they increase morale and become positive role models.

Role Modeling

From early infancy, children learn through their interactions with others. Young children follow examples so it is important for caregivers to be good role models. Children pick up on attitudes and behaviors, including eating habits.

Up, Up, and Away!Transforming Movement Into Action

Movement = Physical Activity• Reduces children’s risk of feeling stressed or depressed • Helps kids feel confident about themselves and their

bodies as they grow • Builds children’s strength, flexibility, and endurance • Enhances children’s motor skills, social skills, and brain

development • Helps kids sleep better • More and more evidence shows that children who are

active tend to have fewer behavioral and disciplinary problems, do better in school, and have longer attention spans in class

Active Living• Unstructured physical

activity

• Structured physical activity

• Classroom, school, and community design

Structured Physical Activity

www.healthypreschoolers.com

http://www.healthypreschoolers.com/part-4-structured-and-unstructured-physical-activities

Manipulating Actions

BouncingCatchingKicking

Object HandlingRollingStriking

ThrowingTossingTrapping

BendingPulling

PushingStretchingSwayingSwingingTurningTwisting

Stabilizing Actions CrawlingGallopingHoppingJumpingMarchingRunningSkippingSliding

Walking

Traveling Actions(locomotor movements)

Facilitate Maximum Participation

• Every child should have a prop with which to explore and play. Always inspect props to ensure safety. The use of homemade props along with intentional facilitation can help develop skills in children as well as provide quality interaction time.

• Teachers and caregivers need to be aware of appropriate and inappropriate practices for preschoolers’ play.

Quality Movement Time Children need time to explore, practice, and repeat movement experiences with a variety of props.

Develop Movement Skills and Concepts

•Be aware of the developmental motor sequence in children and teach age-appropriate activities.

Design Active Learning Environments

•Provide an environment where children can move safely and explore. The adult should be actively engaged and prompt questions for exploration and problem solving.

Outdoor PlayOutdoor play is important for preschoolers because movement helps them develop:•Motor skills •Cognitive abilities •Social and emotional competence  •Children’s play is their work! 

Barriers and Opportunities• Administration

• Policies

• Children’s Age

• Staff/Teachers

• Parents

• Other

http://www.azdhs.gov/empowerpack/

Contact Information

Adrienne Z. Udarbe, MS, RD

Community Programs Manager

Bureau of Nutrition and Physical Activity

Arizona Dept. of Health Services

adrienne.udarbe@azdhs.gov

602-364-3298