Nutrition in school-aged children. More recent survey data from the CDC show that in 2009, only 22% of high school students met the recommendation of eating 5 or more servings of fruit and vegetables daily.[27] Increasing fruits and vegetables in the daily diets of children requires access to healthy foods. However, food security for lower-income households with children remained unacceptably low over 10 years of study: only 59%. This is far from the US national goal for food security, set at 94%. Behavioral risk factor surveillance over multiple years has demonstrated disparities in access to healthy foods. Lack of access to healthy foods is particularly problematic in regions of poverty.[28] Therefore, education is needed not only on nutritional needs of children but also on where to access healthy foods.
The nutritional practices of school-aged children are influenced by the nutrition education provided in schools. The national survey School Health Policies and Programs Study (SHPPS) reported that not all regions require teaching nutrition and dietary behaviors in school.[27] At the state level, 72% of elementary schools, 67% of middle schools, and 72% of high schools required teaching about nutrition. Among schools surveyed, approximately 85% required teaching about nutrition. However, in schools where nutrition is taught, healthy eating topics may not be adequately covered. Approximately 25% of school nutrition programming did not include the dietary guidelines for Americans, food guidance using MyPyramid, or preparation of healthy meals and snacks.[27,29] These findings underscore the need for education outside of the school system on nutritional need at each stage of childhood, and the need for healthy dietary behaviors.
The type of food available to students may limit their opportunities to make healthy eating choices. The SHPPS shows that whereas only approximately 68% of schools offered breakfast to students, nearly all offered lunch. Many schools include brand-name fast foods as options for their students. Only approximately half of schools surveyed offered low-fat options as a la carte foods, and half used healthy food preparation practices.[27] A recent study of more than 4000 students in Florida public schools demonstrated that 18% of middle school students bought less healthy snacks, including candy, chips, and soda, from vending machines rather than purchase the school lunch.[30] In addition, the nationally representative School Nutrition Dietary Assessment Study found that children's consumption of sugar-sweetened beverages in schools contributed significantly to their daily caloric intake.[31] Attending a school without a snack bar reduced consumption of sugar-sweetened beverages significantly in middle school and high school children.[31] School-aged children and their mothers, parents, and caretakers need information on healthy choices to improve these dietary behaviors.
Nutrition in early childhood. Nutrition in very young children is controlled by the choices and behaviors of their mothers, parents, and caretakers. In infancy, breastfeeding has a positive effect on the health of the child. Breastfeeding is associated with reduced risk for obesity through adolescence and into adulthood, according to a recent review of the evidence.[32] The odds of obesity were reduced among children who were breastfed in 28 of the 29 studies compared in this review.[32,33] In another meta-analysis of 9 studies of pediatric overweight, breastfeeding decreased the risk for overweight.[34]
The longer a child is breastfed, the less likely he or she is to be overweight as a child, according to recent studies. A 30% decrease in the odds of being overweight was reported for children breastfed for 9 months, compared with children who were not breastfed.[35] Yet, current statistics on breastfeeding rates from analysis of the National Immunization Survey in the United States indicate that although 74% of infants initiated breastfeeding, only 42% continued for 6 months and only 11% were breastfed exclusively for 6 months.[36] The education of mothers about breastfeeding is one of the best ways to improve these statistics, according to the recommendations of the Division of Nutrition and Physical Activity, National Center for Chronic Diseases Prevention and Health Promotion.[37] Continuing bottle-feeding longer in infancy has been suggested as a potential risk factor for obesity. In the United States, approximately 75% of children are bottle-fed longer than the recommended 12 months. In a study of 12- to 36-month-old children, continued bottle use was significantly associated with obesity.[38] Furthermore, 2 prospective trials have shown that providing nutrient-enriched formula in infancy causes increased fat mass in 5- to 8-year-old children compared with normal formulas.[39] These studies show that education is needed to increase awareness of the benefits of breastfeeding and risks of continued bottle feeding for mothers, parents, and caretakers of infants and very young children.
Studies of infants and children up to 4 years of age show ethnic differences in obesity risk factors in the home environment. A recent study of more than 1300 child-mother pairs reported increased odds of obesity risk factors among certain groups; introduction of solid foods before 4 months of age, higher intake of sugar-sweetened beverages, and higher intake of fast foods were greater for black children and Hispanic children in their preschool years.[40] Disparities in healthy nutrition early in life are important areas of education for mothers and caretakers if we are to address disparities in obesity that can have a negative effect on health throughout life.
Nutrition in school-aged children. More recent survey data from the CDC show that in 2009, only 22% of high school students met the recommendation of eating 5 or more servings of fruit and vegetables daily.[27] Increasing fruits and vegetables in the daily diets of children requires access to healthy foods. However, food security for lower-income households with children remained unacceptably low over 10 years of study: only 59%. This is far from the US national goal for food security, set at 94%. Behavioral risk factor surveillance over multiple years has demonstrated disparities in access to healthy foods. Lack of access to healthy foods is particularly problematic in regions of poverty.[28] Therefore, education is needed not only on nutritional needs of children but also on where to access healthy foods.
The nutritional practices of school-aged children are influenced by the nutrition education provided in schools. The national survey School Health Policies and Programs Study (SHPPS) reported that not all regions require teaching nutrition and dietary behaviors in school.[27] At the state level, 72% of elementary schools, 67% of middle schools, and 72% of high schools required teaching about nutrition. Among schools surveyed, approximately 85% required teaching about nutrition. However, in schools where nutrition is taught, healthy eating topics may not be adequately covered. Approximately 25% of school nutrition programming did not include the dietary guidelines for Americans, food guidance using MyPyramid, or preparation of healthy meals and snacks.[27,29] These findings underscore the need for education outside of the school system on nutritional need at each stage of childhood, and the need for healthy dietary behaviors.
The type of food available to students may limit their opportunities to make healthy eating choices. The SHPPS shows that whereas only approximately 68% of schools offered breakfast to students, nearly all offered lunch. Many schools include brand-name fast foods as options for their students. Only approximately half of schools surveyed offered low-fat options as a la carte foods, and half used healthy food preparation practices.[27] A recent study of more than 4000 students in Florida public schools demonstrated that 18% of middle school students bought less healthy snacks, including candy, chips, and soda, from vending machines rather than purchase the school lunch.[30] In addition, the nationally representative School Nutrition Dietary Assessment Study found that children's consumption of sugar-sweetened beverages in schools contributed significantly to their daily caloric intake.[31] Attending a school without a snack bar reduced consumption of sugar-sweetened beverages significantly in middle school and high school children.[31] School-aged children and their mothers, parents, and caretakers need information on healthy choices to improve these dietary behaviors.
Nutrition in early childhood. Nutrition in very young children is controlled by the choices and behaviors of their mothers, parents, and caretakers. In infancy, breastfeeding has a positive effect on the health of the child. Breastfeeding is associated with reduced risk for obesity through adolescence and into adulthood, according to a recent review of the evidence.[32] The odds of obesity were reduced among children who were breastfed in 28 of the 29 studies compared in this review.[32,33] In another meta-analysis of 9 studies of pediatric overweight, breastfeeding decreased the risk for overweight.[34]
The longer a child is breastfed, the less likely he or she is to be overweight as a child, according to recent studies. A 30% decrease in the odds of being overweight was reported for children breastfed for 9 months, compared with children who were not breastfed.[35] Yet, current statistics on breastfeeding rates from analysis of the National Immunization Survey in the United States indicate that although 74% of infants initiated breastfeeding, only 42% continued for 6 months and only 11% were breastfed exclusively for 6 months.[36] The education of mothers about breastfeeding is one of the best ways to improve these statistics, according to the recommendations of the Division of Nutrition and Physical Activity, National Center for Chronic Diseases Prevention and Health Promotion.[37] Continuing bottle-feeding longer in infancy has been suggested as a potential risk factor for obesity. In the United States, approximately 75% of children are bottle-fed longer than the recommended 12 months. In a study of 12- to 36-month-old children, continued bottle use was significantly associated with obesity.[38] Furthermore, 2 prospective trials have shown that providing nutrient-enriched formula in infancy causes increased fat mass in 5- to 8-year-old children compared with normal formulas.[39] These studies show that education is needed to increase awareness of the benefits of breastfeeding and risks of continued bottle feeding for mothers, parents, and caretakers of infants and very young children.
Studies of infants and children up to 4 years of age show ethnic differences in obesity risk factors in the home environment. A recent study of more than 1300 child-mother pairs reported increased odds of obesity risk factors among certain groups; introduction of solid foods before 4 months of age, higher intake of sugar-sweetened beverages, and higher intake of fast foods were greater for black children and Hispanic children in their preschool years.[40] Disparities in healthy nutrition early in life are important areas of education for mothers and caretakers if we are to address disparities in obesity that can have a negative effect on health throughout life.
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