NR228 Nutrition

NR228 Nutrition

Day Care

Preschool-aged children

Cultural Mixed

Introduction

The purpose of this presentation is to conduct a nutritional assessment by analyzing, comparing and evaluating different menus in a day-care facility with preschool-aged children in an urban area.

The various cultural group where the children come from include:

Hispanic

African American

European American

Caucasian

Asian

Sample menu 1

Sample menu 2

Current Menu Analysis

Breakfast

Making sure kids and toddlers get a good start to their day,begins with a healthy breakfast.

The children in the daycare eat pumpkin muffins and milk for breakfast.

Replacing the whole milk which contains higher amounts of fats with skim milk which contains less than 0.5% fat would be more healthy.

Current Menu Analysis

Lunch

In the Day-care, chicken nuggets and peas and apples juice are served.

Chicken nuggets contain high salt concentration or sodium chloride (Barros, 2019).

According to Trofholz et al. (2021),homemade,fresh, organic and wholegrain are essential for any meals served to children.

Moreover, the Daycare should have a snack menu between breakfast and lunch.

Current Menu analysis

Snack

In the current menu, the children are served cheese and crackers which contain high amount of fats

Replacing cheese with veggie sticks and adding low fat milk would add value to the current snack (Park et all.,2019)

This Photo by Unknown Author is licensed under CC BY-NC-ND

(menu)

Breakfast

½ cup of 100% orange juice

Ham, egg, avocado and cheese (optional) with whole grain corn tortilla

Lunch

1 sandwich – 2 slices of 100% whole wheat bread with 1-2 oz of meat and cheese (optional), veggies, leafy greens and dressing

Cup of water or ½ cup of whole milk

(optional for those who are lactose intolerance)

Snacks

½ cup of apple slices with peanut butter after breakfast

½ cup sliced banana with frozen yogurt after lunch / baked chips

(Comparisons)

Goal: Well balanced diet

Ingredient list main point complete nutrients: High in vit c, d, a, k, proteins, fiber, and potassium etc

Day care cons:

Cereals are incomplete protein

Pancakes & waffles refined flour and topped with high-sugar syrups. They may promote insulin resistance and increase the risk of obesity, type 2 diabetes and other diseases.

Muffin – same with muffin, but also with refined vegetable oils and high in sugar, calories and fat but low in fiber

Chicken nuggets – provide more fat, less protein, more sodium and more carbohydrates than you’d get from unprocessed chicken

Pizza – high in calories, sugar and sodium. They’re typically highly processed and contain artificial preservatives, added sugar and unhealthy fats.

(Barriers)

Health of population: high rates of obesity, overweight, and diet-related chronic diseases, including cardiovascular disease (CVD), hypertension, dyslipidemia, type 2 diabetes, osteoporosis, and certain types of cancer

Socioeconomic challenges:

Level of income

Pandemic

Food cost

Transportation

No time

Convenience – fast food

Available food

Food processing and manufacture

Organic/nonorganic (not cheap)

Transportation

Food access

Other:

Facility

Budgeting- saves money as possible

Facility bills

Staff

Food

Limited on fund & food source

(teaching Point)

Kids – Growing & developing = need nutrients 

Balance diet

4 food groups

Veggies

Fruits

Whole grains

Protein

Avoid certain things

High sugary

High fat

Incomplete proteins

Process food

Suggestion 

Fruits, veggies & water

Starchy (moderate amount)

Dairy

Lean protein

Tips

Balance food choices

Time

Budget plan

(summary)

In conclusion- my sample meal plan may seem a well balanced diet, but realistically most facilities would be out of business if it’s unaffordable. So ideally they would like to budget as much as possible. The best route they would usually choose is the most affordable meal plan which are usually processed food. Sometimes a few healthy ones. Even though junk food taste better. But at the end of the day, the best source of a good diet is from home. Although it may be challenging but manageable.

Reference

National Academies Press. (n.d.). Overview of Health and Diet in America. Retrieved July 16, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK209844/

Careers in Government. (2017). Why is the US So Unhealthy? Retrieved July 17, 2021, from https://www.careersingovernment.com/tools/gov-talk/career-advice/why-is-the-us-so-unhealthy/

Gerritsen, S., Dean, B., Morton, S. M. B. & Wall, C. R. (2017). Do childcare menus meet nutrition guidelines? Quantity, variety and quality of food provided in New Zealand Early Childhood Education services. Wiley Online Library. Retrieved August 4, 2021, from https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12667

Sample Menu Lacto-ovo Vegetarian

Breakfast

2% milk – (1/2 cup)

1 boiled egg – (1,3oz)

Avocado- (1/2 cup)

Strawberries and banana – (1/2cup)

Lunch Snack

2% milk – (1/2 cup) (½) banana slices with (½tbsp)almond butter

carrots – (1/2 cup) 2% Milk (½ cup)

apples – (½ cup)

Sandwich – (½ egg, 1/2 oz cheese, whole

Grain bread 1oz)

menu comparison breakfast

Fresh fruits, proteins, and grains are not as plentiful on the original breakfast menu. It does not place a priority on providing appropriate nourishment to preschool-aged children. The breakfast food suggested is healthier and adheres to the MyPlate recommendations.

2% milk – (1/2 cup)

1 boiled egg- (1)

Avocado- (½ cup)

Strawberries and banana – (½ cup)

Original menus

Cheerios/peaches/Milk

Pancakes/Milk

menu comparison Lunch

Because it lacks fresh fruits and has more fat and sugar, the sample lunch menu is unhealthy and nutritionally deficient. It does not place a priority on providing appropriate nourishment to preschool-aged children.

2% milk – (1/2 cup)

Carrots – (2 tbsp)

Apples – (1/2)

Sandwich – (1/2 oz egg, 1/2 oz cheese)

Green beans – (2 tbsp)

Original lunch menus

Chicken Nuggets/peas/apple juice

menu comparison Snack

The original snack menu is highly unhealthy and does not adhere to the MyPlate recommendations. It also has a higher calorie, fat, and sugar content. It does not place a priority on providing appropriate nourishment to preschool-aged children.

(½) banana slices with (½tbsp)almond butter

2% Milk (½ cup)

Original Snack Menu

Cheese and crackers/ Milk

Seasonal fruit/ cheese balls

Barriers

Available food sources: preschool aged kids will eat whatever is convenient and given to them easily and affordable.

Culture: In the culture of a preschool aged American kids can be easily influenced by their peers, as well as wanting to eat the same food.

Socioeconomic: The daycares we picked are in considered middle class and upper class there may be some families who are unaware of affordable healthy food options at home or at day because lack of time and food knowledge

teaching point

Available food sources: preschool aged kids will eat whatever is conveniently given to them

The caregivers in charge of feeding the kids, they should be well educated in preschool aged kids nutrition and provide them with foods that will help them grow physically and mentally.

Babies and toddlers need foods from all five healthy food groups – vegetables, fruit, grain foods, dairy and protein.

Limiting the use of salty, fatty, sugary foods, low-fiber processed foods to avoid future bad habits of food choices and occurrence of food related disorders and diseases

Summary

We studied day care menus and made nutritious food choices for preschool aged kids students.

Because preschool-aged children are rapidly growing physically and cognitively, it is critical that they eat nutritious foods to avoid future health concerns.

As nurses, it is our responsibility to provide appropriate nutrition information and resources to individuals of all ages and backgrounds

Finally, we agreed that MyPlate recommendations are a great source for making healthier and more informed food choices for preschoolers and people of all ages.

References:

Age appropriate nutrition. The Administration for Children and Families. (n.d.). https://www.acf.hhs.gov/ecd/age-appropriate-nutrition.

Childcare. HealthySDgov. (n.d.). https://healthysd.gov/category/childcare/.

Early child care nutrition. Obesity Prevention Source. (2016, April 8). https://www.hsph.harvard.edu/obesity-prevention-source/obesity-prevention/early-child-care/early-child-care-nutrition/.

Preschoolers. MyPlate. (n.d.). https://www.myplate.gov/life-stages/preschoolers.

Grodner, M., Escott-Stump, S., & Dorner, S. (2020). Nutritional foundations and clinical applications: A nursing approach. Elsevier.

Sample Menu:

Lactose intolerance

Breakfast A.M. Snack Lunch P.M Snack

1/2 cup Rice Krispies Multigrain ½ Silk Almond-Milk Yogurt Peanut Butter & Banana Slices 1/2 cups of ½ Strawberries

1/2 Cup Almond Milk 1 Small Half of Apple Slice 2 Slices of Whole Wheat Bread

1/2 Cup Raspberries 1 ½ Tablespoon of Natural Peanut Butter

1/2 cup of celery

(Ninaj):

My sample menu is based upon a child that who is lactose intolerant. The food options that were selected are considered to be lactose friendly to the consumer

Comparison Breakfast Menu

Ninaj’s Sample Breakfast Menu

1/2 cup Rice Krispies Multigrain

1/2 Cup Almond Milk

1/2 Cup Raspberries

Original Breakfast Menu

Fruit Loop Cereal

Cinnamon Toast

Mandarin Oranges

Milk

(Ninaj):

The original breakfast menu is high in sugar and contains whole milk. An article in Raisingchildren.net gathered that a child may not have enough lactase within their stomach to properly intake whole milk.(The Australian Parenting Website. 2020, March 13)

Comparison Lunch Menu

Original Lunch Menu

English Muffin Pizza

Fruit Cocktail

Milk

Ninaj’s Sample Lunch Menu

Peanut Butter & Banana Slices

2 Slices of Whole Wheat Bread

1 ½ Tablespoon of Natural Peanut Butter

1/2 cup of celery

(Ninaj):

The original lunch menu are high in simple carbohydrates and refined grains.MyPlate states that “at least half of the grains that you eat should be whole grains”(MyPlate. (n.d.). Grains) The original lunch menu also includes dairy.

Comparison Snack Menu

Ninaj’s Sample Snack Menu

A.M. Snack: ½ Silk Almond-Milk Yogurt

1 Small Half of Apple Slice

P.M Snack: 1/2 cups of ½ Strawberries

Original Snack Menu

Animal Crackers

Craisins

Milk

(Ninaj):

The original snack menu contains high levels of acrylamide, as well as high in sugar. It also contain dairy Center for Environmental Health. (2020, January 28).

Barriers

Available Food Sources: Ages 4-5 years of age typically mirror their superiors. Probably will not consume foods geared to lactose complications.

Culture: African Americans are at the top in having lactose deficiencies

Socioeconomic: Low income/ Middle Class environments might be impacted by food desserts making it challenging to have proper resource per food options.

(Ninaj):

It might be somewhat challenging convincing a child to eat the proper foods that are lactose friendly. The health professionals at University of Alabama at Birmingham announced that 48% of Americans are lactose intolerant and African Americans cultivate about 80% of it (Lactose Intolerance May Not Be As Common As We Thought. (n.d.).

Teaching Points

Lactose intolerant can be managed with the use of medications and or additional supplements that can be taken orally.

Symptoms all include Bloating, Nausea, and Stomach Pains

There are substitutions that can be made in order to get the proper nutrients that needs to be restored.

Summary

Comparing and contrasting the daycare menus allow for things to be a bit clearer in regards to the challenges that daycares face when trying to distribute the proper food care plan in order for the child to have the highest optimal attention when consuming food during breakfast, lunch, and snack time.

References

Center for Environmental Health. (2020, January 28). Animal Crackers. https://ceh.org/products/animal-crackers/

Golisano Children’s Hospital. (n.d.). Lactose-Free Diet – Pediatric Nutrition – Golisano Children’s Hospital – University of Rochester Medical Center. Https://Www.Urmc.Rochester.Edu/. Retrieved August 15, 2021, from https://www.urmc.rochester.edu/childrens-hospital/nutrition/lactose-free.aspx

MyPlate. (n.d.). Grains | MyPlate. Myplate.Gov. Retrieved August 14, 2021, from https://www.myplate.gov/eat-healthy/grains

The Australian Parenting Website. (2020, March 13). Lactose intolerance: babies, children and teenagers. Raising Children Network. https://raisingchildren.net.au/guides/a-z-health-reference/lactose-intolerance

Sample Menu

MENU PLAN			WEEK ONE
Week one	Monday	Tuesday	Wednesday	Thursday	Friday
BREAKFAST	Oatmeal & Blueberries Whole Milk	Fresh Fruit & Wheat Toast Whole Milk	Scrambled Eggs & Applesauce Whole Milk	Cheerios Banana Whole Milk	Wheat French Toast Orange Slices Whole Milk
SNACK	Bananas & Yogurt Apple Juice or Water	Celery sticks with peanut butter & raisins Whole Milk or Water	Whole Wheat Muffins Apple Water or Apples Juice	Granola Bar Whole Milk or Water	Whole Wheat Muffins Apple Water or Apple Juice
LUNCH	Spinach Spaghetti w/Sauce Whole Milk	Chicken Nuggets w/ Sweet Potato & Peas  Whole Milk	Turkey Rice balls w/ Sweet Potato Mash Whole Milk	Chicken meatballs w/ Spinach pasta Whole Milk	Veggies Tenders W/ Broccoli Whole Milk
SNACK	Hummus & Whole Wheat Pita Bread Water	Banana Boats (PB & Raisins) Whole Milk	Cheese & Veggie Sticks Whole Milk	Fruit w/ PB Dip Whole Milk or Water	Veggies with Dip Whole Milk or Water

Menu Comparison

Breakfast

Replacing the high starch oatmeal with waffles and cereals contains little lower starch helps keeps absorption of other nutrients in check.

The whole milk can be replaced with skimmed milk to limit intake of fats.

Adding fruits such apples to the breakfast would ensure the children get much required vitamins.

Menu Comparison

Lunch

Instead of using juice with added sugars, we suggested the use of chopped fruits such us chopped bananas.

Moreover, the cheese put on the suggested menu is grilled cheese instead of the normal cheese.

Barriers

Availability of food varieties

Economic challenges whereby some food such as skimmed milk is more expensive compared to whole milk (Grodner et al.,2020)

Environment barriers and cultural challenges whereby some culture or nor like milk products

Nutritional Needs by Age Summary Teaching Points

Fruits and Vegetables are essential part of every meal for preschool-aged children (Sirasa et al.,2019).

Any meat such as chicken nuggets and sweets should be avoided.

The children in daycare should be physically active and enjoy the food with others.

Nutritional Needs of Preschool-aged Children Summary

Reference

Barros, J. C. (2019). Healthier chicken nuggets incorporated with chia (Salvia hispanica L.) flour and partial replacement of sodium chloride with calcium chloride. Emirates Journal of Food and Agriculture, 794-803.

Park, M. H., Bae, Y. J., & Choi, M. K. (2021). Maternal correlates of vegetable preference and consumption in preschool-aged children. Journal of Nutrition and Health, 54(1), 54-66.

Sirasa, F., Mitchell, L. J., Rigby, R., & Harris, N. (2019). Family and community factors shaping the eating behavior of preschool-aged children in low and middle-income countries: A systematic review of interventions. Preventive medicine, 129, 105827

Grodner, M., Escott-Stump, S., & Dorner, S. (2020). Nutritional foundations and clinical applications: A nursing approach (7th ed.). Elsevier.

Trofholz, A. C., Tate, A., Keithahn, H., de Brito, J. N., Loth, K., Fertig, A., & Berge, J. M. (2021). Family meal characteristics in racially/ethnically diverse and immigrant/refugee households by household food security status: A mixed methods study. Appetite, 157, 105000.