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Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
Feeding children, feeding ourselves 011513
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Feeding children, feeding ourselves 011513

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  • How does farm policy play out in the grocery store? Fresh fruits and vegetables cost more
  • I say be careful what you wish forOnly 2/10 are fast food entrees: pizza, chicken strips and fries
  • Mean anthropometric measures in children 2-18 years of ageNHANES Data 1999-2004 –24 hour recall 32% children; 30% of adolescents reported candy consumption day of recallCandy consumers have lower weight lower BMI lower waist circumference than non consumers
  • Candy consumers (w/ lower weight, BMI, waist circ) eat more calories
  • Should BMI be used diagnostically?Mostly it is a screening tool
  • Transcript

    • 1. Challenges in NavigatingToday’s Abundant Food Supply Bonnie Y. Modugno, MS, RD www.muchmorethanfood.com 1
    • 2.  “There is no one recommendation for a healthful diet” 2010 Dietary Guidelines Advisory Committee Report, 2
    • 3. What are families eating? AmericaMenzel and DiAluisio. Hungry Planet: What the World Eats. © 2005 3
    • 4. GuatemalaMenzel and DiAluisio. Hungry Planet: What the World Eats. C 2005. 4
    • 5. 5
    • 6. 6
    • 7. Percent of foods with 1-3 stars100 90 80 70 60 50 40 30 20 10 0 total produce cereals seafood meat dairy soups deli items 27,000 foods surveyed Hannaford Markets, 2006http://www.hannaford.com/Contents/Healthy_Living/Guiding_Stars/gs_faq.shtml 7
    • 8. 70 60Establishments per 1000 residents 50 40 LA County 30 West LA 20 South LA 10 0 Convenience Small food Medium Sized Large Store Store Market Supermarket Sturm and Cohen. Zoning for Health, Health Affairs 28(6) 1088-1097. c 2009 8
    • 9.  2010 Adam > 30 BMIDrewnowsky (UW) study 45 40 35 30 Funded by NIH grant 25 20 15 2001 Seattle shoppers 10 > 30 BMIin low cost vs. high priced 5 0grocery storeshttp://www.msnbc.msn.com/id/37280972/ns/health-diet_and_nutrition/t/pricey-grocery-stores-attract-skinniest-shoppers/#.T4ioY9m8S5J 9
    • 10. Cost of food 1985-2000 Soft Drinks Fats/Oils Eggs Sugar/Sweets Poultry % Increase Red Meat Dairy Cereal/Bakery Fish Fr and Veg Fr. Fruit and Veg 0 50 100 150USDA Data 2002 10
    • 11. 90 Soda 80 70 Bread Cost in cents 60 Potato September/2011 food costs chips 50 Cookies 40 This is how the USDA farm Licorice 30bill subsidizes our food supply Orange 20 10 Apple 0 Carrots 100 Calories 11
    • 12.  It’s not a matter of availability. All of the stores in his study stocked a wide range of nutritious food, including plenty of fruits and vegetables.  Healthy, low-calorie foods cost more money and take more effort to prepare than processed, high- calorie foods.  “We can’t assume that access is sufficient.”http://www.msnbc.msn.com/id/37280972/ns/health-diet_and_nutrition/t/pricey-grocery-stores-attract-skinniest-shoppers/#.T4ioY9m8S5J 12
    • 13. 13
    • 14. 30% of all calories consumed as snacks Map for convenience stores in LA 14
    • 15. 15
    • 16. Crispy Calimari w/ vegetables Pork Milanese Personal Meat Lovers PizzaChicken Strips w/ fries and gravy 2/10 “fast food” Large Tuna Melt Sunrise Quesadilla… Fat Kcal Calories Smokin Q 3 Pack Burger w/… Grannys Country Omelet Jalapeno Smokehouse Bacon… Ribs and More Ribs 0 500 1000 1500 2000 2500 http://www.nowpublic.com/health/forbes-top-10-most-fattening-chain-restaurant-meals-calorie- menu 16
    • 17. Calories Added Sugar (tsp) 16 14 12 10 Home 8 Restaurant 6 Added Fast Food 4 Sugar School 2 Other 0USDA: Table 1—Daily intake of food at home and away from home NHANES 2003-4 17
    • 18. Calories Added Fats (gm) 45 40 35 30 Home 25 Restaurant 20 15 Added Fast Food 10 Fats School 5 Other 0USDA: Table 1—Daily intake of food at home and away from home NHANES 2003-4 18
    • 19. 19
    • 20.  Movie Theaters 5 oz. boxes of candy 500-750 Calories 32 oz. beverages 406 Calories 8 cups of buttered popcorn 440 Calories 20
    • 21. Theme Parks 4 oz. cookies  493 Calories 8.5 oz. cinnamon roll  872 Calories 8 oz pecan roll  716 Calories 21
    • 22. 807060 T. Candy -Cons50 T. Candy- NC40 Choc-Cons.30 Choc-NC20 Sugar-Cons10 Sugar-NC 0 Weight (kg) BMI Waist Circ. (cm)http://www.eurekalert.org/pub_releases/2011-06/fl-nss062811.php 22http://www.foodandnutritionresearch.net/index.php/fnr/article/view/5794/8675
    • 23. 24002300 T. Candy -Cons2200 T. Candy- NC2100 Choc-Cons.2000 Choc-NC Sugar-Cons1900 Sugar-NC1800 Calorieshttp://www.foodandnutritionresearch.net/index.php/fnr/article/view/5794/8675 23
    • 24.  Food marketing  Maternal agepractices  Assortative mating Physical activity  Sleep debt Infections  Endocrine disruptors Perinatal epigenetic  Pharmaceuticalfactors iatrogenesis  maternal obesity  Ambient temperature  over/undernutrition  hyperinsulinemia 24Critical Reviews in Food Science and Nutrition 49(10) 868-913 (2009)
    • 25. Proposed model of fetal programming of offspring of women with abnormal metabolic environment (increased insulin resistance). Catalano P M Reproduction 2010;140:365-371 25© 2010 Society for Reproduction and Fertility
    • 26. Changes overtime for studyoutcomes Ebbeling, C. B. et al. Arch Pediatr Adolesc Med 2003;157:773-779. 26Copyright restrictions may apply.
    • 27. NW Obese Lomenick J P et al. JCEM 2009;94:4463-4471 27©2009 by Endocrine Society
    • 28. NW Obese NW Pre-adol. Obese Pre-adol. Lomenick J P et al. JCEM 2009;94:4463-4471 28©2009 by Endocrine Society
    • 29. 29
    • 30. SUMMARY We live with an abundant and adulterated food supply There is no one right way to eat Body size should not be the litmus test for what one gets to eat Conventional dietary recommendations may actually increase risk of obesity for vulnerable children 30
    • 31. FEEDING CHILDREN, FEEDING OURSELVES It is not where you eat. It is what you eat when you get there. 31
    • 32. Q&A Bonnie Y. Modugno, MS, RD www.muchmorethanfood.com 32
    • 33.  BMI is an important indicator of overweight and obesity inchildhood and adolescence. When measurements are taken carefully and comparedwith appropriate growth charts and recommendedcutoffs, BMI provides an excellent indicator of overweight andobesity sufficient for most clinical, screening, and surveillancepurposes.Himes. Pediatrics Vol. 124 No. Supplement 1 September 1, 2009 pp. S3 -S22 33
    • 34.  BMI is a poor surrogate measure of adiposity  Compared w/ dual energy x-ray absorptiometry, excessive body fat was found in  77% of children w/ BMI > 95th %  20% of children w/ BMI between 85-94th %  50% of children have “moderate” adiposity  30% of children have “normal” body fat storesFreedman, et al. Classification of Body Fatness by Body Mass Index–for-AgeCategories Among Children Arch Pediatr Adolesc Med. 2009;163(9):805-811. 34

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