This lecture covers dietary needs in children and teens. The lecture will include ways to cope with fussy eaters, myths about what foods are healthy/unhealthy, and how weight issues can affect self-esteem and future health problems.

1. Open up and say…AHH!
Children, eating and you
Presented by:
David Levine MD
4/29/14

2. "Eat food. Not too much.
Mostly plants."

3. Pop Quiz, Hotshots!
1) Is 2% milk better than whole milk?
- How much decrease in fat is this from
whole milk, 98% or 1%?
2) Is there cheese is cheez wiz?

4. Which is worse? Salt, sugar or fat?
- need to know about food in order to
understand how to feed your child
- need to know how food is manipulated
in order to educate your child and
protect them and their health

5. • Real, unprocessed food, sends signals to the
brain that make you feel full fast
• Processed foods (Coke, Doritos, etc..) don’t
send the same signals so you end up
consuming more!
• and the food processors know and exploit this

6. Worry about predators…

7. Food and Family

8. Hopefully not this…

9. Nutrition
• Prenatal
• extremely important
• you don't fix things with 9 mths of
healthy eating after a lifetime of bad

10. Newborn/Infant
• breast is best
-but there is reality
-different formulas
-marketing vs. reality

11. Introduction of complementary foods
• no right or wrong way to start
• we all prefer sweets
• some evidence to support meat early (iron)
• not before 17 weeks (allergy)
• Solids (finger foods) start with pincer grasp (9-
10mths)

12. One Year
• switch to whole milk?
• dairy (yogurt, cheese)>>milk
• ok to continue breast
• ever expanding diet

13. Toddlers
• food rules
• options/menu
• don't reward with bad
food for eating good food

14. • eating after the toddler period is
determined very much by this
developmental period and how you
interact with the child
Are YOU picky?
• anxious about your weight?
• dieting?

15. It’s good to play with food!

16. BMI
• body mass index (wt for ht)
• measured after 3 years of age
• healthy weight/overweight/obese/morbidly obese
• a child who is overweight/obese at 5 years of age is
likely to have weight problems as an adult
• not a guarantee

17. To organic or not to organic,
that is the question.

18. • less pesticides
• better for you?
• more expensive, or is it?
• the type of animal you eat may be less
important than what THAT animal ate
while it was alive

20. • -omega 6:3 ratio should be roughly 1:1
-grass fed is 1:1
-corn fed is 14:1
• heart disease risk? cancer risk?
• THERE IS A DIFFERENCE!

21. Vegetarianism
Vitamins can make this a non-issue in the US
• should consult with a trained nutritionist to insure that
there are no gaps, especially in children with growing
bodies (different from adults)
i.e. vit B12, fatty acids, iron
• vegetarian vs vegan (too restrictive for child?)
• leaner bodies, probably will live longer and healthier
lives

22. Beef is Bad! (sorry hamburger lovers)
• especially commercially produced
• E. Coli 0157:H7
• -In and Out Burger (1980's)
• byproducts fed to animal include bits from the same
species
-cannibalism
-mad cow disease

23. Reading is fundamental...

24. Antibiotics

25. • superbugs
- MRSA
- E. Coli
• overuse of ABX leads to resistance
• all promoted and approved by your government and
the FDA/USDA

26. What's a parent to do?

29. FOOD = HEALTH
• top causes of death, most are food
related
- heart disease
- cancers

30. • we all want what is best for our kids
• so why do we place so little care on what they eat?
• why do we not trust our own instincts when it comes to
food?
- internet? fad diets? mistrust of MD's?
- lack of education/information from MD's?

31. Do we need these?

32. Maybe not…

33. • science has not yet provided concrete answers
• many different theories exist
• confusing to doctors and patients
• epidemics of obesity and diabetes cannot be ignored
• all of us have our biases (mine is added sugars)
-added sugars will soon be noted on nutrition labels

34. A spoonful of sugar?
• More like a few gallons
- soda consumption has doubled since the 70’s
- each person consumes about 40,000 gallons soda/yr
= 60,000 calories
= 3700 tsp sugar/person (about 22 tsp/day, goal is 5-10)
- 5 tsp = 6oz Coke, one Twinkie, 1.5 Fig Newtons
-How? Marketing and Conditioning (expect sweet, reject when not)
- Beyonce, Taylor Swift, Lebron James….

35. • why does BK and McD's cost less than real food?
- corn subsidies
- business invades science (remember tobacco?)
• lack of real oversight
• lack of caring by government (more business than
people)

36. Speaking of corn
• High fructose corn syrup
 Roughly the same sweetness of sugar, but way cheaper
 More stable, keeps packaged goods fresher, longer
 Worse than sugar?
• May lead to increased trigylcerides, LDL and other heart disease
markers (Fructose = Fat?)
• Doesn’t mean table sugar (sucrose: ½ glucose, ½ fructose) is better

37. Obesity is the new smoking
• it is costing us billions right now
• may have peaked, but still a major
problem
• trying lots of different methods
-none are proven to work

38. And a little about fat
• Bliss points
 Fat has none, just keep eating it
 Usually don’t even know it is there

39. Don’t be so Cheesy!
• Milk fat must go somewhere
• Consumption has increased
• Average person: sat fat increased by
200 gram/year
• Finds it way into more foods as an
additive (not high quality cheese, i.e.
American cheese PRODUCT)

40. Prevention always trumps
treatment

41. • harder than it looks
• requires commitment
• watch TV, or play
• priorities!
• Time?

42. What to do?
• teach your kids
• take them food shopping
• cook with them
• microwaving is NOT cooking!
• your job is to provide, their's is to eat
• young children can adjust their intakes, but cannot
choose a well-balanced diet

43. • aim for 3 meals/day (age appropriate)
• avoid sodas and teas
-water
-100% juice (in moderation)
-milk (no more than 8 oz, low fat unless 12-24 mths)
-routine use of vitamins NOT necessary
• NO HIGH FRUCTOSE CORN SYRUP!

44. • EAT WITH YOUR KIDS!
• don't get caught up in lower percentiles if your kids is
happy and energetic
• gaining wt on bad food is worse than being skinny or
stable on healthy food
• petition your school and elected officials for better
food

45. Don't do this!

46. It isn't easy, but it is worth it