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July 2008
Understanding the nutrition facts label
The importance of stretching
Breastfeeding can help reduce the risk of overweight
NEW (Nutrition, Exercise and Weight Management) KidsTM continues to expand
YMCA Youth Super Sports is a great way for kids to get moving |
Understanding the nutrition facts label
By Jennifer Allen, RD
The nutrition facts label is a great tool for pediatric patients concerned about weight management. However, many patients find the label to be confusing and difficult to use. Here's how you can use the nutrition facts label with pediatric patients.
- Check the serving size. All of the numbers listed on the label are based on a single serving of the product. Compare the portion you are consuming to the serving size. Inform your patients that many packages that appear to have only one serving often have two or more servings.
- Calories count. Total calories is the key number to look at for those trying to decrease energy intake for weight management. When comparing two products, select the one with fewer calories. Remember to make sure you are comparing two products with the same serving size.
- Know which nutrients to limit. When comparing products, look for lower amounts of the following:
- Total fat.
- Saturated fat.
- Trans fats.
- Cholesterol.
- Sodium.
4. Focus on a few nutrients to include, such as fiber and micronutrients.
- Fiber plays a critical role in weight management. It provides little to no digestible calories and promotes satiety.
- It also is important to include good sources of micronutrients (Vitamin A, Vitamin C, Iron, and calcium) in a child's diet.
- Use the percentage of Daily Values to identify good sources of micronutrients and fiber (more than 20 percent can be considered a good source of fiber, less than five percent is a poor source of fiber).
5. The footnotes are not for kids. The percentage of Daily Values and the
references listed on the bottom of the label are based on a 2,000-calorie diet –
typically too much for kids. Don't use these numbers to determine how much
a child needs.
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The importance of stretching
By Stacy Stolzman, MPT
Do all kids need to stretch? Yes. Aren't most children very flexible? Yes, but as children become less active and put on more weight, muscle groups can become tight, leading to joint pain, frequent injuries and poor body mechanics. Stretching exercises can be a simple way to get children to start an exercise routine in their own homes.
According to the Mayo Clinic1, the top five benefits of stretching include:
- Increased flexibility and joint range of motion: Flexible muscles can improve daily functional mobility, allowing children to ride bicycles, climb playground equipment and walk faster.
- Improved circulation: Stretching increases blood to muscles. This increases nourishment and decreases waste by-products in the muscle tissue. Improved circulation can help decrease recovery time after injuries.
- Better posture: Consistent stretching keeps muscles from getting tight and allows children to maintain proper posture. Good posture keeps joint pain away.
- Stress relief: Stretching helps relax tight and tense muscles that often accompany stress.
- Enhanced coordination: A full range of motion in the joints keeps us balanced. Coordination and balance will help children stay mobile and prevent injuries that often result from falls.
Studies have shown that range of motion can be increased by a single 15- to 30-second stretch for each muscle group per day. Studies also show that after six weeks of daily stretching, those who stretch for 30 seconds per muscle each day increased their range of motion more than those who stretched 15 seconds per muscle group per day. Another six-week study found that one hamstring stretch of 30 seconds each day produced the same results as three stretches of 30 seconds2.
The latest research concludes that stretching should be completed with these techniques in mind to avoid unnecessary injury:
- Warm up first.
- Hold each stretch for 30 seconds.
- Do not bounce.
- Focus on a pain-free stretch.
- Relax and breathe freely.
- Stretch both sides (both legs, both arms, both sides of the neck, etc.).
- Light stretching should be done after a warm up and a more thorough stretching routine should be done after physical activity.
Children and adults can participate in stretching exercises together. Parents can help their children get into the proper position and hold it for 30 seconds. Check out the links below for stretching pictures and instructions.
Warm up stretches
Cool down stretches
Science News for Kids
References
1. http://physical therapy.about.com/odflexibilityexercises/a/stretchbasics.htm
2. http://sportsmedicine.about.com/cs/flexibility/a/aa022102a.htm
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Breastfeeding can help reduce the risk of overweight
By Michele Polfuss, RN, MSN, APNP
Breastfeeding can have many benefits. Common medical benefits to the child include lower risk for ear and respiratory infections, gastroenteritis, type 2 diabetes and sudden infant death syndrome. Another benefit that has been assessed is whether breastfeeding will reduce the risk of overweight in our pediatric population.
The Centers for Disease Control has an excellent resource called the Weight Management Research to Practice Series. In July 2007, the CDC reviewed the topic of breastfeeding and its relation to overweight. It reviewed three meta-analyses that were published in 2004 and 2005, breastfeeding rates and evidence-based interventions that were designed to promote breastfeeding.
Highlights of findings
- Two of the analyses reported that initiation of breastfeeding was associated with reduced risk of pediatric overweight.
- The duration of breastfeeding was found to be inversely related to pediatric overweight. In one of the analyses it was found that for each month of breastfeeding up to age 9 months, the odds of overweight decreased by four percent.
- Exclusive breastfeeding was found to have a stronger protective effect than breastfeeding that was combined with formula feeding.
Possible explanations for findings
- Breastfed infants control the amount of milk they consume. Because of this, their self-regulation of energy intake allows them to better respond to their internal cues of fullness. The formula-fed infant may be encouraged to complete formula feeding.
- Insulin concentrations in the blood differ by feeding choice. Formula-fed infants have higher plasma insulin concentrations and a more prolonged insulin response. This may stimulate more deposition of fat tissue which increases weight gain, obesity and risk of type 2 diabetes.
- Higher protein found in formula may stimulate the secretion of insulin.
- Leptin (a hormone thought to inhibit appetite) may be influenced by breastfeeding.
- One study found that children who had the highest intake of breast milk early in life had more favorable leptin concentrations relative to their fat mass.
Breastfeeding rates
Healthy People 2010 aims to increase breastfeeding rates so that:
- Seventy-five percent of all new mothers initiate breastfeeding.
- Fifty percent of all new mothers continue breastfeeding six months postpartum.
- Twenty-five percent of new mothers continue to breastfeed at least one year postpartum.
Additionally, Healthy People 2010 hopes that:
- Sixty percent of new mothers practice exclusive breastfeeding for the first three months of their child's life.
- Twenty-five percent practice exclusive breastfeeding for the first six months of their child's life.
Division of Nutrition and Physical Activity: Research to Practice Series No. 4: Does breastfeeding reduce the risk of pediatric overweight? Atlanta: Centers for Disease Control and Prevention, 2007.
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| Michelle Polfuss, RN, MSN, APNP | NEW Kids continues to expand
By Brian Fidlin, PsyD, program director, NEW Kids Program
The Milwaukee area has shown dramatic increases in the rates of pediatric overweight and obesity during the past several years. The average body mass index for children ages 13 and older referred to the NEW (Nutrition, Exercise and Weight Management) KidsTM Program has increased by at least 1.0 each year for the past five years. The needs of this population also have grown dramatically. To better serve children and families affected by overweight and obesity, NEW Kids is expanding its services.
Michele Polfuss, CPNP, brings to the NEW Kids team a wealth of experience from Children's Hospital of Wisconsin-Fox Valley. While there, Polfuss where led Committed to Families, its pediatric weight management program.
With the addition of Polfuss to the team, NEW Kids is able to increase the number of evaluations and decrease time to next appointment. A child referred to the NEW Kids Program may be seen as in as little as four weeks. Polfuss' also will help coordinate communication between the many care providers that our patients often require. |
YMCA Youth Super Sports is a great way for kids to get moving
By Sydney Hofer, YMCA of Metropolitan Milwaukee
One of the biggest challenges for kids who are struggling with their weight is getting enough physical activity. YMCA Youth Super Sports can help get kids moving and bring families together in the process. Programs at the youth level are noncompetitive, with a focus on learning basic skills. Every child gets to play. There are programs available for kids as young as preschool.
Kids who play Youth Super Sports get more than physical activity. They learn other life skills like discipline, teamwork and cooperation. One Youth Super Sports coordinator gives his athletes a different word to focus on, using the YMCA core values of caring, honesty, respect and responsibility, along with sportsmanship and teamwork. He then helps them carry those values off the playing field.
YMCA Youth Super Sports is a progressive program with three levels:
- Rookies (ages 4-7) participate in pre-competitive developmental programs to learn game fundamentals and have fun through modified game activities.
- Winners (ages 8-16) participate in a values-based program that combines modified and regular game play with drills to give kids a solid understanding of the game as well as build team skills and self-confidence.
- Champions (ages 8-16) are youth at the winners level who choose to participate in this personal achievement program that challenges and rewards kids for learning about the game and for building character.
YMCA Youth Super Sports programs are fun for the whole family. Parents can volunteer to be coaches and help out with practices. Game days can be a family affair with moms, dads, brothers and sisters cheering in the stands.
Sports offered include basketball, soccer (indoor and outdoor), track and field, coach-pitch baseball, tee ball and flag football.
Youth Super Sports participants are introduced to sports in a fun, non-threatening way. Many don't even realize they are making a healthy choice to be active because they are having so much fun. The things these young athletes learn on the field also can be applied to everyday life.
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