Day :
- Pediatric Nutrition
Pediatric Obesity Prevention
Breast feeding Importance
Session Introduction
Laura Rodriguez
University of Texas at El Paso, USA
Title: Title: Reducing childhood obesity: Opportunities for engaging families in school settings
Time : 11:25-11:55
Biography:
Laura Rodriguez received her Doctor of Nursing Practice degree in 2013 from the University of Texas at El Paso. She is a Clinical Assistant Professor and the Director for the Traditional Nursing Undergraduate Program at the University of Texas at El Paso School of Nursing. She is the Course Coordinator of the Senior Nursing Practicum. Her expertise is in Pediatric health. She has presented at local and state conferences on health related topics as well as academic topics. Presentations range from ‘Childhood Obesity Interventions’ to the ‘Use of Guided Refl ection for Nursing Students’.
Abstract:
The incidence of childhood obesity has dramatically increased in the last 20 years. Currently about 1 out of every 3 children in the United States is overweight. Furthermore, the incidence of childhood obesity in the US is 17% and the incidence in El Paso, Texas mirrors this statistic. Various interventions have been utilized to decrease these numbers. Most experts agree on a family approach to tackling this issue with education as one key component. A project was employed at a local charter school in El Paso, Texas. The prioritized population was sixth graders due to the obesity among these youth based on school data. The project focused on the concepts of portion control based on the “Choose My Plate” initiative from the US Department of Agriculture. Educational sessions were performed in a classroom setting with the child and at least one parent. Parents completed a post-intervention survey to evaluate their acquisition of knowledge. 75% of parents were able to state the proper portion control for fruits, vegetables, grains and protein. The high number of correct responses to the proper portion size suggests that the educational sessions were successful and informative for those who participated. The project achieved its objective of teaching the parents and the children about proper portion control & nutritional label reading & food preparation tips for reducing childhood obesity.
Kristen Altdoerffer
Drexel University, USA
Title: Title: Breastfeeding: Is society catching up with a miracle of nature?
Time : 11:55-12:45
Biography:
Kristen Altdoerffer DNP, CRNP, CPNP-PC is an Assistant Clinical Professor of Nursing at Drexel University and a pediatric nurse practitioner working with Advocare Newborn Network. She has completed her Doctorate of Nurse Practice at the University of Maryland in 2015. She is board certified as a pediatric nurse practitioner and enjoys practicing with newborns, adolescents, and the underserved population. Her passion is education, especially pertaining to breastfeeding. She is a member of NAPNAP, active on the Delaware Valley Chapter’s Legislative Committee and the Grants Chair, and on The Pennsylvania’s Coallition of Nurse Practitioners's Campaign Committee.
Abstract:
Breastfeeding is the perfect feeding method for newborns due to its perfect fat and protein composition, the passive maternal antibodies, increased maternal bonding, the newborn’s decreased occurrence of allergies, asthma, obesity, SIDS and otitis media, and the ongoing alteration of nutrients coinciding with the newborn’s nutritional needs. Science is just starting to discover the details of milk composition, and breast milk’s roles in immunology and building the infant’s gut microbiome. Although breastfeeding has been the oldest method of feeding, society has just recently started to adapt to be a more breastfeeding friendly culture. The Affordable Care Act has expanded coverage to include breastfeeding counseling, pumps, and supplies, and also mandates employers to provide nursing mothers a location and work breaks to pump, and the U.S. Surgeon General’s Call to Action to Support Breastfeeding encourages a national shift . Recent literature has provided further evidence on the importance of breastfeeding, milk banks and breastfeeding clinics are expanding, and some state legislation has been passed to further protect breastfeeding rights.
Ann W. Lambert
Auburn University School of Nursing, USA
Title: Title : Exploring preventive strategies of childhood obesity through prenatal education
Time : 12:45-13:15
Biography:
Mrs.Lambert completed her Masters degree in Maternal Child Nursing and is full time faculty at Auburn University School of Nursing with classroom and clinical responsibilities for Pediatirc Nursing. She also maintaints her practice as a Pediatric Nurse Practitioner in primary care. She has over 30 years experience in nursing and teaching nursing students. She has presented at the state level and poster presentations at the national level. She is invovlved in Outreach Projects related to Childhood Obesity, Safe Sleep and promoting Breastfeeding.
Abstract:
This project developed and evaluated a prenatal educational intervention designed to modify mothers’ behaviors that may reduce the risk of childhood obesity in her offspring. We identified prenatal factors associated with early childhood obesity from a literature review and the focus group findings. The focus group reported poor food choices, lack of exercise, excess weight gain, gestational diabetes, smoking and bottle feeding as compared to breastfeeding as prenatal factors affecting childhood obesity. Physicians were also asked how to intervene with patients who have one or more risk factors. The focus group suggested verbal, written/brochure and video media for education. They also suggested referral to a specialist if needed. A survey was conducted to ascertain perceptions among regional obstetrical healthcare providers, including physicians and certified nurse midwives (CNM), related to preventing early childhood obesity. Healthcare providers, who participated in the survey, agreed that childhood obesity could be due to the parental diet choices and physical activity opportunities. Based on participants’ responses of potential risk factors for childhood obesity, they believed that maternal diabetes, gestational diabetes, excess gestational weight gains, lacking awareness of appropriate weight gain during pregnancy, and high birth weight of the infant were major risk factors to childhood obesity. Some of them considered maternal malnutrition to be a risk factor, but some did not. These professionals did not consider smoking and alcohol as risk factors for childhood obesity. Most of them believed that breast-feeding could protect the infants from childhood obesity. Both physicians and CNMs had similar perceptions toward these risk factors. Physicians and midwives suggested the most feasible methods of education about prenatal factors and childhood obesity would be a brochure or verbal information. An evidence-based educational brochure and video were developed and delivered within the healthcare provider setting, including local Obstetrics offices and childbirth preparation classes. We evaluated the effectiveness of the intervention through our pilot study. Participants in the pilot study were 36 pregnant females aged from 17 to 40. The pre- and post-survey were administrated before and after presenting the educational materials, including oral, written, and video. The results indicated that after receiving the educational materials, participants’ knowledge about the risk factors related to childhood obesity during the prenatal stage was increased. However, their attitude did not change. As for the educational materials, most of them considered the video was the most useful, attractive, and helpful. The second most useful, attractive, and helpful method was the oral education. Only half of the women considered the written material as useful, attractive, and helpful.
Mary Sowa
CHOC Children’s Hospital, USA
Title: Title: Implementing a pediatric registered dietitian (RD) residency program
Time : 14:15- 14:45
Biography:
Mary Sowa has received her BS in Dietetics and Food Administration and MS in Sports Nutrition at California State University, Long Beach. She has credentials in Pediatric Nutrition (CSP), Nutrition Support (CNSC) and Lactation Education (CLEC). She has worked as a Pediatric Clinical Dietitian at CHOC Children’s Hospital for over 20 years and currently covers the metabolic service. Along with working as Clinical Nutrition Director, she organized and implemented the hospital’s RD Residency Program.
Abstract:
Clinical Nutrition and Lactation Services at CHOC Children’s, Orange, California, implemented a pediatric registered dietitian (RD) residency program in 2013 to provide training for dietitians new to pediatric nutrition. The program has been extended from 16 to 18 weeks and is off ered twice yearly. To date we have held six sessions. Residency rotations include a variety of specialty areas in both the inpatient and outpatient settings. Th e outpatient areas include: Gastroenterology, Diabetes, Pulmonary and Cystic Fibrosis, Ketogenic and Metabolics. Th e inpatient areas include: Medical/Surgical, Oncology and Bone Marrow Transplant and Intensive Care Units (Pediatric, Cardiac and Neonatal). Curriculum for each specialty area includes text and/or journal references, a slide presentation providing an overview of the area, and a pretest to assess baseline knowledge. During each rotation, the RD resident works alongside the preceptor and is given opportunities to provide medical nutrition therapy with increasing autonomy. Each specialty rotation ends with a post-test or case study and monthly evaluations are used to review feedback from each preceptor. To further assess competence and autonomy, staff relief is used throughout the program. In addition, the resident completes a project for the department. Our experience shows a pediatric RD residency program is beneficial to both the hospital and the dietetics profession. Th e organization has been able to train and evaluate an individual in the clinical setting before potentially hiring them for an internal candidate. Funding for the residency was obtained through a variety of sources who had donated to the CHOC Children’s Foundation.
Nehal El Koofy
Cairo University, Egypt
Title: Titile :Patterns of nutrition and sport supplements use in young Egyptian athletes: A community based cross sectional survey
Time : 14:45-15:15
Biography:
Nehal El Koofy has completed her MD in Pediatrics from Cairo University, Egypt. She is a Professor in Pediatrics at Cairo University. She is a Member in Pediatric Hepatology Unit and assists in the nutrition unit activities. She had a Clinical Nutrition Diploma from the American University, Cairo. She is also a Member in the Council of Clinical Nutrition Egyptian Fellowship and has published more than 20 papers in reputed journals.
Abstract:
Background: Adequate nutrition intake is crucial for promoting athletic performance, particularly for adolescents. We aimed to investigate the pattern of basic and sport nutrition as well as perspectives of young Egyptian athletes. Methods: Structured interview survey measuring knowledge, attitudes, beliefs and behaviors about basic and sport nutrition was administered to adolescent athletes recruited from 4 sport clubs and 2 fitness centers in Greater Cairo governorate. Results: A total of 358 participants aged 13-18 years completed questionnaires. Basic nutrition knowledge was reasonable in almost all domains except fast food. Fixed breakfasts (78.5%), home meals (lunch, 70.7%) and healthy snacks (55.8%) were the most positive features of the basic dietary pattern. More than 70% perceived themselves as knowledgeable about sport nutrition. The prevalence rate of sport supplement intake was (48.9%, n=175), predominantly sport drinks (66.9 %) and creatine (54.3%). Coaches were the primary source of sport nutrition information. Forty-four percent of participants (n=77/175) reported supplement consumption during competition seasons only. Better physical appearance and enhancement of athletic performance were the major motivations for supplement intake. Conclusion: These findings indicate the necessity of a comprehensive nutrition education program targeting not only athletes and parents but also coaching staff , health trainers and all sport team officials.
Marilyn King Hightower
Baylor University , USA
Title: Title: The application of social justice to address food insecurity in a baccalaureate nursing curriculum
Biography:
Ms. Hightower is a graduate of Baylor University Louise Herrington School of Nursing and a graduate of Texas Woman’s University with a MSN with an emphasis in Education and the role of a Clinical Nurse Specialist. She was a Clinical Nurse Specialist for 13 years at Children’s Medical Center Dallas, and has been in Nursing Education for 12 years. She is an Associate Clinical Professor at Baylor University Louise Herrington School of Nursing, Dallas, TX.
Abstract:
All children deserve to live in a food secure environment. In the United States, 14.3% of all households and 21% of all children met the US Department of Agriculture (USDA) definition of a food-insecure household. Households with children are twice as likely to be food- insecure as households without children. Poverty is not the sole cause of food insecurity since 30% of food-insecure households fall above the $23,643 federal poverty threshold for a family of 4 people, and fall above 185% of the threshold amount, which is $44,093. Children living in food-insecure households are more likely to be sick, recover more slowly from illness and be hospitalized more frequently than children living in food secure households. Food insecurity adversely affects physical growth, cognitive abilities, behavioral health and the emotional health status of children. Poverty is also linked to the development of obesity in both adults and children; food-insecure households have limited access to high-quality foods, tend to live in food deserts, and are more likely to substitute fast foods for nutritionally sound foods. Children living in households with persistent food insecurity are 22% more likely to develop obesity when compared to children living in food-secure households. All health care professionals must be taught to screen for food insecurity, advocate for protecting and increasing access to existing food programs, and work to advance the offering of nutritionally sound foods in existing programs such as WIC, SNAP and school nutrition programs. Poverty and food insecurity are two of the social determinants of health along with income disparity, health inequality and homelessness that are included in a BSN Community Health Nursing course. Additionally, ethical principles and the tenants of social justice are provided as a foundation for community/population health and public health. The social determinants of health and the tenants of social justice are intangible concepts for the student to grasp since it is difficult for most students to relate to another’s circumstances unknown to themselves.
- Diagnosis Techniques for Pediatric Malnutrition
Pediatric Nutrition in Chronic Diseases
Session Introduction
Mohammed Srour
Al-Azhar University–Gaza, Palestine
Title: Title: Challenges facing adequate estimation of micronutrient defi ciencies among children in Palestine
Time : 11:10-12:00
Biography:
Mohammed Srour has completed his PhD from Vienna University. He is currently a Lecturer at Clinical Nutrition Master Program in Al Azhar University Gaza. He is also working in many NGOs and national agencies on nutrition and food security.
Abstract:
Assessment of nutritional status among vulnerable groups especially children in communities living under harsh conditions has a unique considerations and significance, an accurate estimations for the micronutrients depend mainly on both appropriate facilities and well trained staffs, meanwhile, influenced by funding availability, validity of the national nutrition strategy, local authorities and NGOs willing and commitment, besides presence of micronutrients database. In the Palestinian national authorities (PNA) territories and due to political situation, social and religion barriers, many constraints are influence the micronutrients surveys, giving unrealistic data resulting in inadequate nutritional interventions. In Gaza strip around 13% of children fewer than 5 are stunted, 57 % of the children 6-36 month suffering from anemia and 27% under 59 month diagnosed with VAD. Although existing some micronutrients data in PNA territories, but it seems that the data are not reflecting the status quo, thus, there is ultimate need to establish a scientifi c executive body responsible for guiding and monitoring the micronutrients surveys in PNA territories, not only that but also data interpretation and providing recommendations. All of that will not be achieved without complete coordination between UN agencies, local authorities, scientific committees and working NGOs. Understanding the underlying causes which lead to insufficient and inadequate micronutrients surveys helps in designing appropriate and effective surveys, which is reflected on the quality of the nutritional intervention.
Nehal El-Koofy
Cairo University, Egypt
Title: Title: Copper concentrations in Egyptian infants with cholestasis: A single center study
Time : 12:00-12:30
Biography:
Nehal El Koofy has completed her MD in Pediatrics from Cairo University, Egypt. She is a Professor in Pediatrics at Cairo University. She is a Member in Pediatric Hepatology Unit and assists in the nutrition unit activities. She had a Clinical Nutrition Diploma from the American University, Cairo. She is also a Member in the Council of Clinical Nutrition Egyptian Fellowship and has published more than 20 papers in reputed journals.
Abstract:
Background: Biliary excretion is the major elimination route of Copper (Cu). Intrahepatic and extrahepatic cholestasis can interfere with biliary excretion, producing Cu retention in the liver. Hepatic Cu accumulation is cytotoxic and results in fibrosis in hepatic tissues. Aim: To evaluate utilization of serum Cu and ceruloplasmin as predictors of hepatic Cu levels in infants with cholestasis. Subjects & Methods: The present study included 41 cholestatic infants, their aged ranged between 1 and 7 months; 26 (63.5%) were males. All cases showed elevated liver enzymes with normal synthetic functions. Histopathology showed picture of neonatal hepatitis in 58.5% infants and extra-hepatic biliary atresia (EHBA) in 41.5% infants. Eleven healthy infants served as controls, their ages ranged between 3-18 months. Serum Cu and ceruloplasmin were done for both cases and controls. Hepatic Cu content were assessed in cholestatic infants. Results: Cholestatic infants had significantly higher levels of serum Cu and ceruloplasmin than controls and their hepatic Cu concentration was significantly higher than literature control. Serum Cu showed positive correlation with serum ceruloplasmin and tissue Cu. Also, serum ceruloplasmin showed positive correlation with tissue Cu. Intrahepatic cholestasis and EHBA showed no significant difference regarding all Cu indices. Conclusion: Serum and hepatic Cu concentrations were markedly elevated in patients with cholestasis and positively correlated with each other and with serum ceruloplasmin. Serum Cu and ceruloplasmin can be used in clinical practice as a simple, cheap and non-invasive test to predict hepatic Cu contents which is measured by a sophisticated, costly and invasive technique.
Lauren Schaffer
Mayo Clinic, USA
Title: Title: Nutrition knowledge in pediatric and adolescent athletes
Time : 12:30-13:00
Biography:
Lauren Schaffer is a current undergraduate student at the University of Pennsylvania majoring in Biology. She plans to attend medical school after earning her Bachelor of Arts degree. She has published 3 papers in medical peer-reviewed journals with more under review and is currently in a summer research program at the Mayo Clinic.
Abstract:
Despite the extensive research to determine the proper diet for children and create appropriate programs and policies, there has been little inquiry as to whether children themselves know what they should be eating. Childhood obesity has reached a prevalence of 20% of all children in the United States (US) and is recognized as a risk factor for obesity during adulthood, as well as other diseases during childhood and adulthood. It is, therefore, an epidemic at the forefront of many physicians’ and lawmakers’ minds. While healthier options have been added to school lunches, more physical activity has been incorporated into the school day, and nutritional information has been made more available to parents, the movement to end childhood obesity will likely only succeed if the children understand what proper nutrition is. It is ultimately the child’s responsibility to choose the healthy option, and while children are increasingly doing so, there is still considerable room for improvement. Furthermore, many children, even those in healthy weight ranges, suffer from nutrient deficiencies, which can have serious consequences. This survey-based study (results pending) aim to investigate elementary school-age children’s knowledge of nutrition. The findings will suggest whether our society needs to place a higher priority on teaching young children healthy eating, instead of simply providing them with healthy food and not explaining its nutritional benefits. They will also give an indication of how much children may know about the relation of what they eat to what they can do in sports and other physical activities, the latter being a focus of more recent efforts to stem the tide of chronic illnesses in the US population.