Nutrition for Life! What starts here Lasts a Lifetime! Helen J. Binns, MD, MPH Professor of Pediatrics and Preventive Medicine

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1 Nutrition & Children s Health Helen J. Binns, MD, MPH Professor of Pediatrics and Preventive Medicine Northwestern University Feinberg School of Medicine Ann & Robert H. Lurie Children s Hospital of Chicago National Conference of State Legislatures August 7, 2012 Nutrition for Life! What starts here Lasts a Lifetime! 2 1

2 Nutrition for Life! Nutritional exposures influence lifelong risk for disease Good nutrition promotes: Brain development Growth Immune function 3 Nutritional Exposures Change Biologic Risk 4 2

3 Essential Micronutrients Iron Zinc Folate Iodine B12 Vitamin A Calcium Thiamin Vitamin C Vitamin D Learning, memory, behavior Immune function Neurologic development, learning Thyroid function, learning Neurologic function, DNA synthesis Vision, immune status Bone formation, cardiac function Neurologic, cardiac function Brain function, energy Calcium absorption, immune status 5 Fruits and Vegetables: Benefits Vitamins Minerals Phytochemicals Vitamin C Vitamin E Potassium Selenium Niacin Iron Vitamin B6 Zinc Thiamine Copper Folate / folic acid Iodine Riboflavin Magnesium Chromium Carotenoids Fiber 6 3

4 EAT! Fruits and Vegetables Essential vitamins & trace minerals Antioxidant role --- fight free radicals and reactive oxygen species Tasty (provides color, flavor, texture, bulk, fiber, satiety without adding lots of calories) 7 The Bad Guys: Oxidative Stress 20% of oxygen breaks down to Free Radicals & Reactive Oxygen Species Stressors can increase that to 80% 8 4

5 The Good Guys: Antioxidants Antioxidants Vitamin C Vitamin E Carotenoids (Vitamin A) Indirect effects Vitamin B6 Riboflavin (B2) Vitamins Food sources Citrus fruits; other fruits & leafy vegetables Vegetable oils, nuts, whole grains, green leafy, avocado orange foods, greens, green veggies, tomatoes Fortified cereal, banana, fish, poultry, greens Fortified cereal, broccoli greens, mushrooms, asparagus, lentils Selenium Zinc Copper Iron Minerals Food sources Grains, seafood, muscle meats, fortified cereals, mushrooms, asparagus, spinach Shellfish, red meat, nuts, legumes Organ meats, shellfish, nuts, seeds, whole grain, wheat bran, mushrooms, potatoes, greens Non-heme: fortified cereal, plants, dairy products, meats 9 Heme: meat, fish, poultry Regulation of Eating Family & Social Influences Sensory factors: Taste Smell Texture Sight Effects of: Variety Sensory-specific satiety Palatability Food concentration Ready availability from Rolls ET. Obes Rev 2007;8(suppl 1):67-72 Cognitive factors: Conscious rational control Beliefs about the food Advertising Brain mechanisms: Modulate sensory factors by satiety signals to produce reward value and appetite Satiety/hunger signals: Adipose tissue signals Gut hormones Gastric distension Weight 10 Status Food Content Eating 5

6 Brain Signaling of Eating I m full PYY (peptide YY) Insulin Leptin CCK (cholecystokinin) I m hungry Ghrelin 11 Fat is VERY Metabolically Active Lipoprotein lipase Hypertension Inflammation a TNF α CRP Atherosclerosis IL-6 Adipsin (Complement D) Adiponectin Angiotensinogen Plasminogen activator inhibitor-1 (PA-1) Insulin Free Fatty Acids Resistin Leptin Lactate Atherogenic Dyslipidemia id i Type 2 Diabetes Thrombosis CRP = C-reactive protein; IL-6 = interleukin-6; TNFα = tumor necrosis factor-alpha 12 Slide Source Lipids Online Slide Library 6

7 Child Factors Associated with Higher Weight Rapid rate of eating High food-cue responsiveness More focused on food More impulsive when making food choices More motivated for immediate rewards, such as good taste Low satiety responsiveness (don t feel full) Presence of these traits does not guarantee expression Child traits provide a risk Environmental influences, such as parenting practices, turn these behaviors on or off 13 Early Obesity and Parental Obesity Obesity as Young Adult by Child & Parent Obesity 90% 80% 70% 60% 50% 40% 30% 1-2y 3-5y 6-9y 10-14y 15-17y 20% 10% 0% Neither parent obese 1-2 parents obese Neither parent obese 1-2 parents obese Child not obese Child is obese % Obese as Young 14 Adult Whitaker et al, N Engl J Med 1997;

8 Lasting Tips for Healthy Eating Health habits developed early last for a lifetime. Modeling of healthy eating by parents and peers influences child eating patterns. Provide an array of healthy options at home and school. 15 8