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لاس 12 6 نينس ناكدوكرد هي ذغت

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Feeding school age children&adolescence

• -School-aged children (ages 6 to 12) continue to need healthy foods and nutritious snacks . They have a consistent but slow rate of growth and usually eat four to five times a day (including snacks).

• Dependent to family than school • -Many food habits, likes, and dislikes are established during this time.

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• -Family, friends, and the media (especially TV) influence their food choices and eating habits -School-aged children are often willing to eat a wider variety of foods than their younger • .

siblings -Eating healthy after-school snacks (sandwiches…….) are important, as these snacks may contribute up to one-third of the total calorie intake for the day • . -School-aged children have developed more advanced feeding skills , are better at feeding skills, and are able to help with meal preparation.

Breakfast is a main meal Wake up earlier Always serve breakfast, even if it has to be "on the run ." Some ideas for a quick, healthy breakfast include the following: • • • • • • fruit milk bagel cheese toast cereal peanut butter sandwich

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Take advantage of big appetites after school by serving healthy snacks such as the following: • • • • • • fruit vegetables and dip yogurt sandwich cheese and crackers milk and cereal

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Allow children to help with meal planning and preparation.

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Serve meals

at the table

, instead of in front of the t

elevision

, to avoid distractions.

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Healthy food choices: Chronic disease prophilaxis(diabetes.m,malignancies,…… Carbohydrates 50% ,prot 15% ,fat 30%(10%sat,10%un sat,15%bivalent) of cal intake limit Sweet,fat Diet Icrease demand in ca,riboflavin,nicotinic Acid,vit D,…..

Demand to near to2000Kcal/day (70Kcal/kg/day)

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The food guide my pyramid is a guideline to help you and your child eat a healthy diet .

The food guide my pyramid can help you and your child eat a variety of foods while encouraging the right amount of calories and fat.

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Most U.S. professional organizations and governmental agencies recommend the use of the USDA MyPyramid (www.mypyramid.gov

) as a basis for building an optimal diet for children and adolescents

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MyPyramid is based on the Dietary Guidelines for Americans.

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A personalized eating plan based on these guidelines provide, on all the essential nutrients necessary for health and growth, while limiting nutrients associated with chronic disease development.

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MyPyramid is aimed at the general public and differs from previous versions of the food pyramid in many ways.

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The intent is to primarily use MyPyramid as an Internet interactive tool that allows customization of recommendations, based on age, sex, physical activity, and, for some populations, weight and height.

• Print material is also available for families without Internet access

• • 1-Proposed daily food intake pattern: How many cup(oz) or srv for how much cal • • • 2-Energy level for proposed intake pattern: Based on sex,age,activity Calculation of EER • • 3-Nutritional goal for proposed daily food intake For each group (AGE,SEX) how mach vit A E C,……,FE,CA,ZN,…Carbohydrate,fiber,prot,fiber.,,...

4-Nutrient profile of food guide pyramid food groupe and subgroups Each cup fruit,vegtable,meat,… contain: how much vit a,c,tiamin,B6,B12,….how much ca,Mg,….how much cal,carbohydrate,prot,fiber,fat,,…

Tables:

• The Food Pyramid is divided into 6 colored bands representing the 5 food groups plus oils: • Orange represents grains product.

: Make half the grains consumed each day whole grains . Whole-grain foods include oatmeal, whole-wheat flour, whole cornmeal, brown rice, and whole-wheat bread. Check the food label on processed foods - the words "whole" or "whole grain" should be listed before the specific grain in the • Green represents vegetables : Vary your vegetables. Choose a variety of vegetables, including dark green and orange-colored kinds, legumes (peas and beans), starchy vegetables, and other vegetables.

• Red represents fruits : Focus on fruits. Any fruit or 100 percent fruit juice counts as part of the fruit group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or pureed

• Yellow represents oils : Know the limits on fats, sugars, and salt (sodium). Make most of your fat sources from fish, nuts, and vegetable oils. Limit solid fats like butter, stick margarine, shortening, and lard, as well as foods that contain these.

• Blue represents milk : Get your calcium-rich foods. Milk and milk products contain calcium and vitamin D, both important ingredients in building and maintaining bone tissue. Use lowfat or fat-free milk after the age of two years. However, during the first year of life, infants should be fed breast milk or iron-fortified formula . Whole cow’s milk may be introduced after an infant’s first birthday, but lower-fat or skim milk should not be used until the child is at least two years old.

• Purple represents meat and beans : Go lean on protein. Choose low fat or lean meats and poultry. Vary your protein routine - choose more fish, nuts, seeds, peas, and beans

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It should be noted that a diet based on MyPyramid, in order to provide all the necessary nutrients

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MyPyramid also provides information on discretionary calories, which are the foods that are not included in MyPyramid guidelines because of their low nutritional value, such as sweetened beverages, sweetened bakery products, or higher-fat meats.

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It allows a very small amount of discretionary calories available each day. The vast majority of children and adolescents do not consume a diet that follows the recommendations of MyPyramid.

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In general, intake of discretionary calories is much higher than recommended, with frequent consumption of sweetened beverages (soda, juice drinks, iced tea, sport drinks), snack foods, high-fat meat (bacon, sausage), and high-fat dairy products (cheese, ice cream).

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Intake of dark green and orange vegetables (as opposed to fried white potatoes), whole fruits, reduced-fat dairy products, and whole grain is typically lower than recommended.

• Furthermore , unhealthful eating habits—such as larger-than recommended portion sizes; food preparation that adds fat, sugar, or salt • skipping breakfast and/or lunch • fad diets—is prevalent and associated with a poorer diet quality.

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Therefore, MyPyramid offers a helpful and customer-friendly tool to assist pediatrician counseling families on optimal eating plans for short- and long term health.

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Activity is also represented on the pyramid by the steps and the person climbing them, as a reminder of the importance of daily physical activity

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According to the Dietary Guidelines for Americans 2005, a decrease in energy intake of 50 to 100 calories per day for children who are gaining excess fat can reduce the rate at which they gain weight. With this reduction in energy intake, they will grow into a healthy weight as they age. Help your child to find higher-calorie foods that can be cut from his/her daily intake

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Nutrition and activity tips

Try to control when and where food is eaten by your children by providing regular daily meal times with social interaction and demonstration of healthy eating behaviors .

• Involve children in the selection and preparation of foods and teach them to make healthy choices by providing opportunities to select foods based on their nutritional value.

• • For children in general, reported dietary intakes of the following are low enough to be of concern by the USDA : vitamin E, calcium, magnesium, potassium, and fiber. nutrients when possible.

Select foods with these

• Parents are encouraged to provide recommended serving sizes for children.

• Parents are encouraged to limit children’s video, television watching, and computer use to less than two hours daily and replace the sedentary activities with activities that require more movement.

• Children and adolescents need at least 60 minutes of moderate to vigorous physical activity on most days healthy weight during growth.

for maintenance of good health and fitness and for • To prevent dehydration activity is completed.

, encourage children to drink fluid regularly during physical activity and drink several glasses of water or other fluid after the physical

• At home , much of what children and adolescents eat is under the control of their parents.

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Typically, parents shop for groceries and they control, to some extent, what food is available in the house

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It has been demonstrated that modeling of healthful eating behavior by parents is a critical determinant of the food choices of children and adolescents .

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Therefore, pediatric counseling to improve diet should include guiding parents in using their influence to make healthier food choices available and attractive at home.

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Regular family meals sitting at a table, as opposed to eating alone, in the living room, or watching television, have been associated with improved diet quality, perhaps because of increased opportunities for positive parenting during meals.

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Such an ideal situation is recommended but a challenge for many families who, with busy schedules and other stressors , are unable to provide such a setting.

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Pediatricians should work with families to set realistic goals around these eating issues.

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. Another parenting challenge is to control the excess appetite of some children and adolescents

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Useful strategies, when the child is still hungry after a meal, include a 15- to 20-min pause before a 2nd servin

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offering foods that are insufficiently consumed, such as vegetables, whole grains, or fruits.

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Eating at School

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. children take 1 or 2 meals a day in school. Pediatricians and parents should therefore keep themselves informed of the school's nutrition policies and menus standards.

in their districts and advocate for improved

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Where the quality of school nutrition is problematic , a practical alternative is to suggest that children pack their own lunch from home.

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Eating Out

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The number of meals eaten outside the home or brought home from take-out restaurants has increased in all age groups population.

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The increased convenience of this meal pattern is undermined by the generally lower nutritional value of the meals, compared to home-cooked meal

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Typically, meals consumed or purchased in fast-food or casual restaurants are of large portion size , are dense in calories, and contain large amounts of saturated and trans fats, salt, and sugar and low amounts of whole grains, fruits, and vegetables.

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Although an increasing number of restaurants offer healthier alternatives, the vast majority of what is consumed at restaurants does not fit MyPyramid .

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Parents can use these opportunities to teach and model healthful choices within the choices offered.

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an increasing number of meals and snacks are also consumed during peer social gatherings at friends’ houses and parties

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When a large part of a child's or adolescent's diet is consumed on these occasions, the diet quality can suffer , because food offerings are typically of low nutritional value .

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Parents and pediatricians need to guide d teens in navigating these occasions while maintaining a healthful diet and enjoying meaningful social interactions

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These occasions often are also opportunities for teens to consume alcohol ; therefore, adult supervision is important

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Most families intend to provide their children with a healthful diet

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The discrepancy between this fact and the actual quality of the diet consumed by children is often explained by difficulties and barriers for families to make healthful food choices Because the final food choice is made by individual children or their parents, interventions to improve diet have focused on individual changes , but these have had limited success.

knowledge a behavior One of the main determinants of food choice influence these choices. is taste , but other factors also

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. One of the most useful conceptual frameworks to understand the child's food environment in the context of obesity illustrates the variety and levels of the determinants of individual food and physical activity choices.

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Many of these determinants are not under the direct control of individual children or parents • Understanding the context of food that and lifestyle choices helps in understanding lack of changes or “poor compliance” and can decrease the frustration often experienced by the pediatricians who might “blame the victim” for behavior is not entirely under their control.

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Marketing and advertising of food to children is a particularly illustrative aspect of the food environment • Television advertising is an important part of how children and adolescents hear about food

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Additional food advertisement increasingly occurs as brand placement in movies and TV shows, on websites, and even video games.