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Healthy Active Living and Balance Dr. Annick Buchholz, C.Psych. Dr. Laurie Clark, C.Psych. Kelly Heffernan, RD Slide 2 Tonights Agenda What is health? Balancing busy schedules Health at Every Size Balanced eating Physical activity in our daily lives Sleep Body Image and Emotional Health Slide 3 What Is Health? Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. World Health Organization Slide 4 What is a healthy lifestyle for a child ? Basic health behaviours Nutrition Physical Activity, Sedentary Time Sleep Coping and Emotional Development Daily living activities School Homework Extra-curricular Activities Time with family and friends Chores Balance Slide 5 What is a healthy lifestyle for a parent? Basic health behaviours Nutrition Physical Activity, Sedentary Time Sleep Coping and Emotional Development Daily living activities Work Chores Extracurricular activities Family needs Time with family and friends Balance Slide 6 Key Ingredients to Balance Schedules work Do not over schedule Parents self care and mental health count Sleep matters Setting loving limits is important Slide 7 Health at Every Size Diets are harmful and dont work Focus on your childs health behaviours and not their weight Advocate for size diversity Remember to provide children with genuine body image compliments You look great today Slide 8 Who is healthier? Person A Ht: 7 1 Wt: 325 lbs BMI: 32 %BF: 12% WC: 90 cm BP: 114/72 Chol: High HDL, Low LDL, TGs with in normal range Person B Ht: 5 9 Wt: 138 lbs BMI: 21 %BF: 10% WC: 78 cm BP: 122/84 Chol: Low HDL, High LDL and TG Slide 9 Healthy life style versus weight BMI= 32 kg/m2 obese BMI= 21 kg/m2 normal weight Slide 10 Balanced Healthy Eating Slide 11 Each Day, 6-9 year olds require : 5-6 Vegetables and Fruit 4-6 Grains 2-4 Milk and Alternatives 1-2 Meat and Alternatives Fluid requirements based on weight, H20 For Optimal Nutrition, Growth and Development how? Slide 12 Its a Balancing Act 1.Meals 3-4 food groups 2.Snacks 2-3 food groups 3.Eat every 2.5-3 hours 4.Balance over the week Slide 13 Balancing Healthy Eating & the Division of Responsibility Parents provide structure, support and opportunities. Children choose how much and whether to eat from what the parents provide. Ellyn Satter 2011, www.ellynsatter.com Slide 14 Balancing Healthy Eating Food refusal is common for children Vegetables Food Jags are normal Reintroduction is key Parents/caregivers, historically, in an effort to have a healthy child will: Feed frequently Offer large portions Offer preferred foods Offer food in response to crying Coerce with food when available Reward with food Slide 15 Balancing Healthy Eating Traditional feeding and their outcomes : 1.Coercion to eat healthy food = Aversions/Dislikes Slide 16 Balancing Healthy Eating Traditional feeding and their outcomes : 2.Clean your plate = Attention to external cues Slide 17 Balancing Healthy Eating Traditional feeding and their outcomes: 3. Food restriction = Increased desire E.g. Fisher and Birch (1999) preschool aged, allowed certain foods and restricted others. What was the response? Slide 18 Balancing Healthy Eating How can we incorporate treat foods? Slide 19 Balanced Eating & Sugary Sweetened Beverages Sugary beverages include: Sports drinks, energy drinks fruit juice, pop, iced coffee, specialty coffees, others Consumption has been gradually increasing over the past few decades 20% of caloric intake for 4-18 year olds 30% of caloric intake for 1-3 year olds Hassink, Seminarts Ped Surg (2009), 18, 159-167 Slide 20 Balanced Eating & Sugary Sweetened Beverages One of the main contributors to increased energy intake for kids AAP recommends: 4-6 oz (120-180 mL)/day for 1-6 year olds 8-12 oz (240-360 mL)/day > 6 year olds Seach et al, Int J Obes, 34(10)1475-9, 2010 Slide 21 Tips to help with Balanced Eating Provide Structure Eat at a table with no screen on Have family meals more often Make meal time enjoyable and fun Involve kids Encourage variety Healthy plate Allow treats Limit eating out to 1x/week Role model Slide 22 Physical Activity Is movement that increases our heart rate and our breathing and requires muscles to use energy. Slide 23 Physical Activity: Its Rewards Enhances healthy growth and development Promotes coordination and balance Improved sleep Increased concentration Better academic scores Improved self esteem Learn social skills cooperation, teamwork, listening Slide 24 Physical Activity Guidelines Children 5-11 years www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-child-ENG.pdf Slide 25 Intensity Talk www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-child-ENG.pdf 1 10 5-6 1 10 7-8 Slide 26 Sedentary Behaviour Guidelines www.csep.ca/CMFiles/Guidelines/CSEP-InfoSheets-ENG-Children%20FINAL.pdf Slide 27 Screen Time Children and screen time: 6 hrs/day on weekdays 7 hrs/day on weekend days* In 1971, average age a child started watching TV was 4 years; today, it is 5 months** Canadian children spent 62% of their waking hours being sedentary*** *2010 Active Healthy Kids Canada Report Card **Zimmerman et al **Zimmerman et al. Arch Pediatr Adolesc Med. 2007 ***CSEP Sedentary Behaviour Guidelines Leaves little time to be active! Slide 28 We tell our children to be active But have we forgotten that in order for kids to be active, it needs to be easy and natural for them? Slide 29 What can parents do to increase Physical Activity Start early in life Role modeling Balance screen time with active time Variety Dress for success Schedule It! Slide 30 Tips to Tame the Screen Set basic rules & weekly plans e.g. no screen time before homework or chores are done e.g. let your child choose 2 shows or computer/video games they can watch/play each day No watching TV, playing with ipod during mealtimes Choose specific shows to watch avoid TV on as constant background Share expectations with caregivers Childhood Obesity Resource: Obesity Society Participation www.participation.com Slide 31 Sleep Hygiene The promotion of regular sleep Adapted from Early childhood obesity prevention policies. Institute of Medicine. 2011 AgeSleep Needs (Per 24 Hour Period) Newborns (1-2 mo.)10.5-18 hours Infants (3-11 mo.)9-12 hours at night + 0.5 2 hour naps, 1-4x per day Toddlers (1-3 yrs)12-14 hours Pre-schoolers (3-5 yrs)11-13 hours School-aged Children (5-12 yrs) 10-11 hours Teenagers (12-17 yrs)8.5-9.25 hours Slide 32 Sleep Hygiene: Tips for Promoting Sleep Create environments that ensure restful sleep No screen/media where children sleep Low noise and light levels Create a bedtime routine Relaxing activities & tasks before bed E.g. Bath Brush teeth Story/Quiet Time Lights out Routine, Routine, Routine! Slide 33 Going beyond Health Behaviours: Emotional Health We want kids to feel good about themselves What is Body Image? How we think and feel about our bodies How we treat our bodies It is a core component of Self Esteem for people of all ages, including kids Slide 34 Body Image: Where does it come from? Influences: Family what we say & do, how we treat our own bodies Friends & Peers group norms, Community and culture school climate, community celebration of diversity The media a powerful influence & pressure on our youth today Body image messages are ever present and typically state: Thin women are beautiful, successful, and happy Muscular men are handsome and successful Slide 35 Women: The Thin Ideal Slide 36 Men: Muscle, Muscle, Muscle Slide 37 Educate children and youth about how societies image of ideal beauty changes across the years. Slide 38 Its not just teens and adults Slide 39 The Media also Sends Messages about Nutrition Our kids are being targeted by a powerful machine Slide 40 Mixed Messages in the Media around Food Slide 41 6-9 Year Olds Kids are NOT mini adults They are concrete thinkers They have not developed insight or good self-regulation (I am tired so I think I will go to bed now) Our messages to them need to be tailored to their level of understanding Kids LOVE structure Putting It all together: The Balancing Act Slide 42 Kids need to move but they also need downtime We dont want to over-schedule our kids Time to recharge Learning emotion regulation and self-soothing skills Unstructured Play is just as important as structured play Fosters creativity and social development Self determination Schedule in downtime and unstructured play as you would structured activities. Slide 43 Talking to Kids about Nutrition, Physical Activity and Health Remember Kids often think in Black & White Place the key on BALANCE Avoid referring to foods or activities as being either good or bad Focus on the positive kids respond to positive reinforcement more than to punishment Slide 44 Make the Switch Promoting HealthMessages to Avoid Nutrition Colourful plates All FOODS FIT Labelling foods as good or bad Counting calories, fat, etc. Physical Activity Physical Activity is For fun, To connect with friends & family To feel good Physical Activity to work off food Physical Activity to change body shape Slide 45 Make the Switch: Positive Body Image Dont Keep glossy diet fitness & fashion magazines around Criticize your own appearance or clothes in front of children Comment on childs weight/shape Do Teach children to be critical of the media & its messages Focus on the Instrumental, not the Ornamental Provide Opportunities to build self-esteem Slide 46 We Need to Walk the Walk: Parents as Role Models Our own health behaviors Engage in activity yourself and limit your own screen time Make Family time Active time Start with Small Changes & build routine Walk to school (even if only part of the way) with your kids A Saturday walk and then a movie Work at Consistency