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Child & Adolescent Health Statistics
Childhood overweight and obesity is a major public health issue Between 1985 and 1995, obesity prevalence in 7715yr olds tripled. Evidence that obesity is developing at a younger age (AIHW) Study indicated most popular activity reported by children 5-14yrs watching TV and videos (AIHW, 52000) Hrs per week spent watching TV > hrs of physical activity (Geelong study of adolescents) Carmel Lazarus February 2008 Social change influencing food preferences/intake
Carmel Lazarus Nutrition Manager & Consultant Dietitian
Email: email@example.com Ph: 0416482199 University of Sydney
Carmel Lazarus February 2008
28% of Australian children attend LDCC 18% of Australian Children attend family day care 32% attend preschool No. of children in LDCC has doubled from 1991 to 1999 (AIHW) No. of children attending family day care increased by 30% (AIHW), same period Children spend minimum of 8hrs/day at the centres Children may be at the centres 5 days/week Childcare centres should provide 50% of the RDI for all nutrients Carmel Lazarus February 2008
Why is good nutrition important for Childcare?
Start good nutrition habits early Halt the rising prevalence of overweight/obesity Food choices/preferences are developed in childhood Young children’s eating habits influenced by environment, staff other children and parents Children spend a lot of time in childcare Eat at least 1 main meal and 2 snacks
Carmel Lazarus February 2008
Menu Planning Considerations
– Amount of food – Type of food – Variety of food
Menu Planning Considerations
Small amount of foods are eaten often Prefer simplicity Associate food with more than just eating Children will be actively learning during the day Examples set have a great influence on the children
Offer opportunity for exploration/learning Good food habits isn’t instinctive
– Need to be given guidance
Foster formation of sound food habits
Carmel Lazarus February 2008
Carmel Lazarus February 2008
w/meal) 4 x per fortnight Dairy Foods – 3 serves of full cream dairy each day Vegetables & Fruit – Menu includes at least 1 serve of vegetables daily – Menu includes at least 1 serve of fruit daily – Fruit juice.”Healthier food choices for child care centres” Caring for Children. AGTHE.gov.Respect for Children 2. 2003 Nutrition Australia: Menu Planning for Childcare Centres NRVs.Health 8.ncac. 1998 NHMRC Dietary guidelines for Children and Adolescents Carmel Lazarus February 2008 Developing a menu policy Important to know what to measure your menu against Sets guidelines for staff and parents Helps ensure adequate nutrition Liaise with parents and staff in the development Employ a professional eg. rice & pasta – Includes at least 2 serves of bread. culturally appropriate occasions and provide an environment for social learning and positive interaction8. tofu or dried beans – Fruit or vegetable high in Vitamin c is included with the vegetarian meal Nutrition Checklist Snacks – planned on menu – Includes a dairy and/or bread/cereal food Breads. Nutrition Australia: Food and Nutrition Accreditation Guidelines for Child Care Centres. rice.Food.1: Food and drink are nutritious and culturally appropriate and healthy eating habits are promoted 8. Carmel Lazarus February 2008 Carmel Lazarus February 2008 Menu Planning Guidelines Food and Nutrition: Directions for NSW 199619962000. APD Carmel Lazarus February 2008 Nutrition Checklist Caring for the Coast – Central Coast Area Health Service Main Meals – Lean red meat is included at least 4 x per fortnight – Lean white meat is included at least 3 x per fortnight – Vegetarian meal is included at least 2 x per fortnight – Vegetarian meals are based on eggs. Cereals. cereal.2: Staff implement effective and current food handling standards and hygiene practices Quality Area . 2005 NRVs.4 Centre acts to control spread of infectious diseases…….Accreditation Principles www. Nutrition & Fun Activities: ChildrenCentral Coast Area Health Service Nutrition Dept.au Nutrients at Risk Energy Iron Calcium Zinc Quality Area . cheese. is diluted and limited to once per day Carmel Lazarus February 2008 Carmel Lazarus February 2008 2 . pasta – Select high fibre types (multigrain. if served.4: Mealtimes are pleasant.
.will/will not be used as punishment or reward ………………..4 . Staff should sit with children and …………… …….2 – Staff implement effective and current food handling standards and hygiene practices. Children will be encouraged to have hands on experience with……… Only soy milks with…………. will be on display for parents and staff Morning and afternoon tea should include…………. Times a day Meal Period Am tea MON Raisin Toast & Peanut butter Fresh cut fruit Chilli Con Carne & Chips Vanilla Yoghurt Skim Milk Menu TUES WED THURS Crumpet with Spread Fresh cut fruit Vegetable Soup & Bread Custard Toasted Pikelets Fresh cut fruit Vegetable Rissoles Rice pudding English muffin Fresh cut fruit Lunch Macaroni with mince sauce Banana Custard Dried fruit & nuts Pm tea Juice undiluted Croissant Late Pm tea Cheese & Crackers Carrot sticks Grapes Sandwiches Carmel Lazarus February 2008 Carmel Lazarus February 2008 Menu Meal Period Am tea MON TUES WED THURS Case Study – Child Care Centre You are a Consultant Dietitian and you have been asked to review the menu for a child care centre Where would you start? How would you assess the menu? Who would you involve? Raisin Toast & Peanut butter Fresh cut fruit Chilli Con Carne & Chips Vanilla Yoghurt Skim Milk Crumpet with Spread Fresh cut fruit Vegetable Soup & Bread Custard Toasted Pikelets Fresh cut fruit Vegetable Rissoles Rice pudding English muffin Fresh cut fruit Lunch Macaroni with mince sauce Banana Custard Dried fruit & nuts Pm tea Juice undiluted Croissant Late Pm tea Cheese & Crackers Carrot sticks Grapes Sandwiches Carmel Lazarus February 2008 Carmel Lazarus February 2008 Child Care Menu Review Awareness of NCAC (national) guidelines Quality areas Quality Area 2 Respect for Children: 2.Mealtimes are pleasant culturally appropriate occasions and provide an environment for social learning & positive interaction Quality Area 8 Health: 8.Menu Policy Strategies to comply with the menu policy: Milk should be served with……&……. appetising foods Milk served with mid-meals midAll milk should be FCM Soy milks fortified with calcium Fruit juice diluted Lunches contain something from each food group Access to bread / fruit between meals Carmel Lazarus February 2008 Carmel Lazarus February 2008 3 . Child Care Menu Review Is there a policy detailing menu objectives – Food allergy policy – nut-free zone nut– Provide children with at least 50% of their daily RDI in the form of safe. All milk should be…….. Or ………. Dairy should be served………. Children will have access to ……. 8.Food and drinks are nutritious and culturally appropriate and healthy eating habits are encouraged.1 . will be used as a milk substitute Desserts will be based on ………. at all times Fruit juice should be………….
Australia: JB Fairfax Creative Cooking Fairfax NUTRITION IN SCHOOL CANTEENS Carmel Lazarus February 2008 Carmel Lazarus February 2008 4 . Proceedings for GSSI Seminar on Recent Advances in Sports Nutrition. Diet and Exercise Performance: High CHO or high fat? Proceedings for Proceedings GSSI Seminar on Recent Advances in Sports Nutrition.org.ais. consider diet profiles Revise purchasing plans Train staff Inform staff/parents Implement and evaluateFebruary 2008 Carmel Lazarus Carmel Lazarus February 2008 Menu Planning for Athletes MENU PLANNING FOR ATHLETES Event may be big or small – Commonwealth Games to local BBQ for a sporting team Understand your target – catering to different athletes Training vs Competition Fluid Availability Adequate Energy and Protein CHO – consider GI Carmel Lazarus February 2008 Carmel Lazarus February 2008 Menu Planning Considerations Menu Cycle length Meal times Seasonality Food Safety Cost Resources available www.Nutrition Checklist 2 serves bread & cereals 1 ½ serves dairy 1 serve meat/alternatives 1 serve fruit 1 serve vegetables Nutrition Australia Menu Planning for Childcare Centres 2002 Menu Planning for Childcare Centres Know your clientele Conduct a survey regarding food preferences etc Know your menu objectives Have a food and nutrition policy Know your resources available Decide on a menu type Design a menu template Develop recipes Trial recipes and check for menu fundamentals.ais.au/nutrition Burke L. Nutrition sports basics. O’Connor H. Kiens B.au/nutrition www.org. Hay D. Glycaemic Index: It’s role in Sports Nutrition.
2 1 3 3 3 5-11 Menu Planning Considerations for School Canteens Extra Foods Lean meat.9 12-18yrs 121. Amber. whole grains. 2003 The Australian Guide to healthy eating NRVs www.schoolcanteens. deep fried foods. nuts legumes Milk. vegetables. Red Carmel Lazarus February 2008 Carmel Lazarus February 2008 5 .health. fish. to fill the menu – Fruit. of serves 4-7 yrs 1. poultry. cheese Fruit Vegetables.Fresh Tastes Resources Menu Planning for School Canteens NSW Healthy School Canteen Strategy: Canteen Menu Planning Guide NHMRC Dietary Guidelines for Children and Adolescents.nsw.gov.org. sugar sweetened beverages Stoplight analogy: –Green.nsw. therefore should be consumed in limited quantities Red – Foods to be consumed no more than ONCE PER TERM – Confectionary. reduced fat dairy Amber – Foods with some nutritional value but higher in fat and/or energy.au www.edu.au Carmel Lazarus February 2008 Carmel Lazarus February 2008 Menu Planning Guidelines Recommended no.7 8-11yrs 1. yoghurt. AGPS. lean meats.schools.2 1 2 1 2 6.2 ½ 2 1 2 5. legumes Cereals NSW School Canteen Menu Planning Guide Carmel Lazarus February 2008 Increasing levels of overweight and obesity Ideal setting to educate about healthy food choices Need to run at a profit or break even The food preferences of the students may be different to parents School canteens provide a substantial proportion of a student’s daily intake Can put into practice the learnt healthy nutrition messages Can influence food choice at school and the wider community Use the Canteen menu planner Breakfast is often skipped Intake of fruit and vegetables is < desirable Carmel Lazarus February 2008 School Canteen Guidelines Developed in response to the increasing rates of obesity in school children Consistent with healthy eating messages taught in school Aligned with – National dietary guidelines for children and adolescents – Australian Guide to Healthy Eating School Canteen Principles Green – Foods to be consumed freely.au www.
9 million are overweight (2004/5 NHF data) Heart.aihw.School Canteen Guidelines MENU PLANNING FOR HEALTH PROMOTION Carmel Lazarus February 2008 Carmel Lazarus February 2008 Health Statistics 2. and provide the edge Still need to run at a profit Carmel Lazarus February 2008 Natraburgers Peppercorn Meats Carmel Lazarus February 2008 Carmel Lazarus February 2008 6 .9% of all deaths in 2003) Greater proportion premature dealth/illness from excess body dealth/illness fast than tobacco and high BP (2004/5 NHF data) 54% of Australians are not sufficiently active to gain health benefits 8% have diabetes 20% smoke daily 30% have high blood pressure 10% drink at harmful levels Estimates that >50% of premature deaths are related to POOR DIET.5 million Australians are obese (1 in 5 males. Carmel Lazarus www. 1 in 6 females) 4.gov/au/cvd/heartweek February 2008 Menu Planning for Health Promotion Diet related diseases are very costly to the Australian health care care system Australians are spending more on foods prepared outside the home – Both parents working – Less time to prepare – Less skills to prepare/cook Caterers can have an impact in providing more healthy choices Usually needs to be an incentive for promoting nutritious foods – May be a business philosophy – May have theme days to promote the business and offer healthy choices – May provide a niche market. stroke and vascular disease kill more Australians than any other group (36.
30pm 2.30pm 1. AGPS.gov. 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine Food Hamper (donated by David Jones Ltd) 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine 3 x bottles Jacobs Creek Wine 1 Month Free Membership City Gym plus bottle Jacobs Creek Wine Healthy Food Hamper (donated by Coles) $50 Voucher redeemable from Fruit & Vegetables Section of David Lazarus February 2008 Jones plus 1 Month Free Carmel Membership to City Gym SHOPPING PLAZA BONDI JUNCTION Carmel Lazarus February 2008 Heart Week Promotions ENTER TO WIN! Answer this question correctly to be eligible to win one of these fabulous prizes: David Jones Healthy Food Hamper Coles Healthy Food Hamper Orlando Wyndham Estate Red Wines 1 Month membership to the City Gym Peppercorn Low Fat Gourmet Meat True/False: Considerations for a Staff Cafeteria Have potential to be models for healthy environments Captive audience due to position May provide more flexibility and customisation Regular feedback with in house clientele Access service daily Usually long term clientelle – offer choice Carmel Lazarus February 2008 The 7-A-Day Program (a partnership project of the Dietitians Association of Australia and Coles) encourages all Australians to eat 7 serves of fruit and vegetables a day. 2003 NSW Health Menu assessment tool NSW Health Policy Directive “Healthier Food and Drink Choices for Staff and Visitors in NSW Health Facilities” www. Healthy Food Hamper (donated by Coles) 12 packets (1 box) Peppercorn Gourmet Meat plus 1 bottle of Jacobs Creek Wine Food Hamper (donated by David Jones Ltd) $50 Voucher redeemable from Fruit & Vegetables Section of David Jones Ltd.00pm 3.healthyactive.au Carmel Lazarus February 2008 Carmel Lazarus February 2008 7 .00pm 2.30am 12.30pm Prizes will be drawn on Friday. 12th May 2000 at the following times: St Vincent’s Private Hospital Heart Health Promotion Day (outside David Jones).10.00noon 12.00am 11. TRUE / FALSE Carmel Lazarus February 2008 Nutrition Guidelines AGTHE – 5 food groups NHMRC Australian Dietary Guidelines for Adults.30am 11.30pm 3.00pm 1.
Menu Planning Steps Know your customers – Conduct surveys. have suggestion box Menu Planning Steps Search for products and recipes Develop standard recipes Implement and communicate Evaluate the menu regularly – Waste audits – Temperature checks – Taste tests Know you menu objectives/Incorporate Nutrition Goals – The items provided comply with the standards Cater to food preferences. pattern. religious needs Construct menu (cycle. cultural diversity. Heart week or Diabetes week Carmel Lazarus February 2008 Carmel Lazarus February 2008 Carmel Lazarus February 2008 Carmel Lazarus February 2008 Carmel Lazarus February 2008 8 .) Decide on a template – offer variety Carmel Lazarus February 2008 Include Promotional days – Eg.
Worksite Canteen You have been asked to review the menu in a staff canteen. Where do you start? Carmel Lazarus February 2008 MENU BREAKFAST LUNCH Egg & bacon Roll Chicken Burger DINNER MIDMEALS Lamb Curry & Muffins Rice Fish and Chips Steak and Vegetables Lasagne & Salad Cakes Slices Fruit Breakfast with Hot Dog the lot Toast and Spreads Sausages Beef Burger Sandwiches Carmel Lazarus February 2008 9 . The customer satisfaction survey has shown 75% of responses were dissatisfied with the current choices of food and would like to see more healthy options on the menu.Carmel Lazarus February 2008 Carmel Lazarus February 2008 Recipe Development/Product Evaluation Base your menu on the guidelines Design nutritional parameters to assist in evaluating new products for the cafeteria Promote healthy foods Make healthy foods affordable and appealing Promoting/Marketing the Service Include new menus in the organisations newsletters/intranet/email Position healthy foods where they are easily accesses and visible List healthier foods at the top of the menu Use appropriate menu descriptions/symbols/colour codes Ensure healthy foods are as affordable or cheaper Incorporate health promotion days – healthy heart dish (lucky door prize to staff purchasing this) – High calcium/reduced fat desserts during healthy bones week Publish recipes/display recipes of healthy foods Offer free samples of healthy foods being trialled or to be promoted Carmel Lazarus February 2008 Carmel Lazarus February 2008 Case Study .
involve in process Recognise the staff skills and staffing levels Is your Menu Design relevant & appropriate Understand Menu combinations . <3g saturated fat/100g. <350mg Na/100g NSW Health Policy Directive – NSW Health Menu Assessment Tool for main meals: <15g fat.texture / taste / nutrition / presentation / variety Carmel Lazarus February 2008 Carmel Lazarus February 2008 10 . <450mg sodium Carmel Lazarus February 2008 Carmel Lazarus February 2008 NSW Health Policy Directive NSW Health Policy Directive Carmel Lazarus February 2008 Carmel Lazarus February 2008 NSW Health Policy Directive Keys to Menu Planning & Assessment Know your Client preferences & demographics Have Menu Objectives to measure the menu against Familiarise yourself with the relevant tools & policies Understand your budget/food service system/equipment and storage facilities Engage staff.Worksite Canteen Look at the equipment available Staff Skills & Knowledge Standards – – – – Diabetes Australia AGTHE Dietary Guidelines Fresh Tastes School Canteens Buyers Guide NSWSCA Guidelines <800kJ/100g.