Question #1
In designing youth-focused interventions to promote calcium intake, which variables would you chose to focus on and why?
posted by Unknown @ 8:46 PM
18 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
18 Comments:
I would focus on the variables that have been shown as barriers to youth calcium intake. Specifically, these variables may include parental influence, taste preferences, lactose intolerance, body image concerns, and the availability of competitive foods.
I also agree with Breine. As a child the parental influence is quite strong and plays a significant role in the child's decision making. Furthermore, I would also look at the use of other calcium sources besides milk,like if a child refuses to drink dairy, would there be the option for them to have a fruited yogurt, OJ (w/calcium) or some cheese instead, to ensure the calcium intake was adequate at all meals? I would also look at how much food already commonly consumed by the child was or could possibly be bought fortified with calcium. This would show which items could be used to increase calcium while still satisfying taste and other variables.
Breine: This is an interesting aspect of variables to focus on. I agree that the barriers, specifically speaking about the ones you named, are important to consider when designing youth-focused interventions.
Nisa: I agree that non-milk drinkers are becoming more common. It is important to stay up-to-date in order to relay the information to our clients by researching, for example, calcium-rich foods consumed by youth.
I would place a strong focus on parental influence. Because inverventions that focus on the family environment have been shown to be the most effective in increasing calcium intakes among adolescents. Parents can help by simlply offering milk to their children and being a good role model by drinking it themselves. I would also focus on the importance of eating breakfast. Milk and calcium fortified breakfast cereals are popular breakfast options for adolescents. I would also address tast preferences by exposing adolescents and parents to a variety of foods that provide calcium. I think that exercise and bone health should also be addressed in youth-focused inverventions.
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I would focus on areas that might appeal to junior high and high school students, especially because it seems so hard to motivate that age group to develop healthy habits. The first variable I would choose is body satisfaction, since teenage girls are concerned about how they look, and the recent studies that have suggested dairy plays a role in weight loss/weight maintenance. I would also focus on breakfast consumption, mainly because if teenagers consume dairy at breakfast, they will most likely eat it in the form of milk in a bowl of cereal, and cereal is fortified in iron and other nutrients that are important for teenagers.
I would focus on parental controls ans taste preferences with alternatives. I think that children really do model what their parents do and if the parents set the example to drink milk that they children will too. Also have children start drinking young so they can start the habit of drinking milk with meals. If a child does not like milk encourage flavored milks or try to use other calcium rich products like OJ and yogurt. It is also important to make children and adolescents aware of why they need calcium and how they can get enough.
Speaking of flavored milk, has anyone tried vanilla or strawberry flavored milk? I remember tasting them at a Prairie Farms display. They were tasty, but oh so sweet. I can see the youngsters going for the different flavors though. It is important to make it fun for the kids (and adults of course).
At a grade school I was at for rotations they had strawberry and other flavored milks. Strawberry was the biggest seller at that school...even over chocolate. It is extremely sweet and I heard people say that it even made the plain milk taste slightly strawberry flavored simply from being placed in the same cooler! That is some pretty potent stuff. But if the sugar content is that high, I don't know that I would recommend it, especially 3x a day.
As many people have mentioned it depends on the age of the child. I was surprised to read in the article that by the age of 4 taste preferences have been set. This makes it that much more important for parents to develop good habits early on, and being a good role model is pretty crucial. I think that junior high and high school students have a lot more freedom to choose what they want, and parents won't have as big of an influence. I think education on the importance of milk and developing good bone density through exercise is important at this age. Maybe they can use some "scare" tactics like showing good bones versus brittle bones. Those kinds of things have stuck we me over the years. Having the kids also look at their own barriers to drinking milk will help them to make goals to over come them.
I did not even know that they made vanilla flavored milk. I have tried the strawberry milk and it was not that bad. When I was helping with District 87 we had the students sample the strawberry milk and the kids loved it. I do agree that the amount of flavored milk should be limited because it does have additional calories and sugar.
Lisa, Brittany, and Mary Ellen: I agree that working with behavior modifactions, especially in combonation with the parents would be the most effective on calcium rates. Secondly, knowing alternatives is helpful when counseling picky eaters or lactose sensitive adolescents.
Kalee: As dietitians, it is important that we target sensitive topics like weight maintainence and use it to our benefit when promoting calcium. On the "Got Milk" website they have a plethera of catchy messages that teens could related too, one being weight maintaince; another stating that milk has been shown to relieve menstraul cramping in women. All I have to say is, "show me the studies behind that"! On the otherhand, breakfast is another great behavior modification that I think many people forget about!
Brittany and Breine: It is funny you mention flavored milk. My favorite flavor is chocolate. Since working in the schools I have consumed more dairy in 5 weeks then I am willing to admit too. Of course, I limited myself to one chocolate milk a day. Sometimes it just takes a jump start to get someone interested!
Nisa and Brittany: That would be the next concern with flavored milk is the moderation. I agree that flavored milk is a great alternative for maybe one time a day, especially if regular milk is being consumed via cereal. Maybe implementing a yogurt or some cheese and crackers for added calcium.
Mary Ellen: That is an interested point that taste preferences are set at age 4. Who's tastes preference do you think they favor too? Educating this population might be trickier than the high school or junior high population. However, at this age and with 1/3 of their day spent at school, I think it is important to "remind" students of their choices by providing catchy messages that they can relate to.
I agree that the sugar content of flavored milk is high and the quantity should probably be limited. However, I think that I would recommend it if the child will not drink regular milk or eat other types of dairy products. I know that many children are picky and will not touch milk unless it is flavored. Also, it is possible that flavored milk could replace soda for some chidren. My thought behind this is that while the child may be getting more calories and sugar from the flavored milk than from regular milk at least they are getting some nutrtion out of it as opposed to soda which is just empty calories.
Suzie,
I agree with you that sometimes we need little reminders to remember to eat healthy including getting our milk servings in. I think a pretty high percentage of children could tell us one benefit of drinking milk but they still don't get in enough milk/milk sources, they might just need a friendly nudge as a reminder.
Andrea said...
In addition to vanilla and strawberry flavored milks, there is also banana, black raspberry, root beer, cappuccino, and coffee flavored milks. I also remember that strawberry was a huge hit at District 87, more so than chocolate! Apparently, the popularity varies widely by geographic location; in Boston for instance, coffee is the favorite flavor.
Andrea said...
Well, after setting aside my notions that bone health is far more complex than calcium/vit D intake alone, I would also focus on the home environment in conjunction with personal taste preferences. For example, both my parents have always drank buttermilk, which I too love. I seriously doubt I would've even tried it if my parents hadn't had it available to me and/or hadn't been drinking it themselves. My brother, on the other hand, doesn't like the taste of buttermilk and won't drink it.
I think we definitely need to focus on what is happening in the home with the support system to unlock key behaviors that can be modified to promote calcium intake.
Andrea said...
I also wanted to make a comment on just how difficult it can be to reach RDA recommendations for calcium. I, for example, love milk. I absolutely love milk and also buttermilk, yogurt, cheese and most other dairy products. However, I can even have a difficult time acheiving the recommendations. For one thing, three 8 oz servings of milk doesn't even meet the 1300mg recommendation for ages 9-18.
Lisa, Mary Ellen, and Andrea:
As dietetic professionals, we often focus on the numbers: calories, grams, weight (pounds); rather, redirecting our attention to changing habits. For instance, using milk to replace soda at meals despite the flavors or added calories will be more beneficial to adolescents than trying to convince them to drink skim milk. Furthermore, studies have shown that adolescents have more buying power than there parents. I think by working with school aged kids may have an effect on those at-home habits Andrea mentioned.
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