Nutrition, Children and HIV

Nutrition, HIV and Children When it comes to a healthy diet, balance is the key to getting it right. This means eating a wide variety of foods in the right proportions, and consuming the right amount of food and drink to achieve and maintain a healthy body weight.

This isn’t just important for you, it’s important for your whole family too. This pack has been designed is to give you a few basics on nutrients, what foods they’re found in and why it’s important for everyone, most importantly children, to eat healthily.

Nutrients- The basics All nutrients are needed for growth. They are what help our body function and keep us growing, developing and staying healthy! Nutrients are especially important when children are growing as it helps to make this process happen. There are many different types of nutrients, which can seem daunting at first but once you know a little about them it’s a lot easier than you think.

Let’s begin with the basics. There are two main groups of nutrients. These are:

Macronutrients and Micronutrients Macronutrients are needed in large amounts in the body. The nutrients that fall into this category are fats, carbohydrates and proteins Micronutrients are needed in the body in much smaller amounts, but are still essential for growth. The nutrients that are in this category are vitamins and minerals

Let’s explain these further…

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

Minimum amounts are set for the nutrients below, but the body needs them a lot!

Iron keeps their bodies healthy by helping provide a rich flow of oxygen. Eating iron-rich food like red meat, vegetable curry, dried apricots, brown rice, cereal, nuts, pulses and green leafy vegetables will help children concentrate better in school and have lots of energy!

Vitamin C keeps children fit and healthy. Vitamin C is a good friend of iron in the body! It helps iron to be absorbed more easily into the body so both of these nutrients are equally as important. Make sure they get enough fruit and vegetables-broccoli, cabbage, sweet potatoes, oranges, strawberries and kiwis are all great sources!

Calcium gives children strong bones and teeth. Help your children to smile by giving them milk, cheese, green vegetables, dried fruit, pulses, beans and tinned fish. This is especially important because of the recent research into HIV medication potentially causing bone damage. By eating calcium rich foods you can help protect against this.

Folate may not be familiar but they’d feel weak without it. Keep up their energy all year with peas, chickpeas, brown rice, asparagus and broccoli.

Zinc helps children grow to be strong and heals them when they are hurt. Zinc helps cells to grow and function properly in the body.

Vitamin A helps protect against infection and nasty bugs. You can keep children fit and healthy by eating bright coloured foods like carrots, red peppers, oranges and apricots. Oily fish like mackerel and salmon, eggs, liver and dairy products are also great too.

Protein helps the body grow and repair itself. It is essential in children as they are growing so fast, they need protein to help their cells catch up. It’s found in meat, fish, dairy products, seeds, beans, lentils and nuts.

Carbohydrate gives them energy to stay running around all day. The starchy kind is the best- things like pasta, rice, cous cous and potato.

Whole meal bread and cereals are also great too.

Fibre keeps their tummies happy and digestion functioning properly. To help this, children should eat a variety of cereals, beans, lentils, vegetables, fruit, brown rice, whole-meal pasta and bread.

Energy is vital for growth and development. Children are constantly learning new things so they need not only enough energy to concentrate and learn but to play too! Yet too much energy can cause an increase in weight so encourage children to be active. Energy comes from fat, carbohydrate and protein in the diet. Children should get more of their energy from starchy carbohydrates and protein and less from fat.

Prepared for Body & Soul by Lucy Bromley March 2012Š Body & Soul 2012

Maximum amounts are set for the nutrients below, as too much can be bad for your health!

Fat is high in energy. Children do require some fat in their diet, but too much can lead to an increase in weight and higher risk of heart disease in later life. Fat is found in lots of different things - mostly fried foods and sweet things like cakes and biscuits. It is also found in some dairy products like mayonnaise, salad cream and pastry. There are good fats and bad fats though: good fats are found in foods such as oily fish and some nuts.

Saturated fat is the bad type of fat. Too much saturated fat can cause high cholesterol, which can cause a build up of fat in blood vessels over time. This is what can cause an increase in risk of heart disease. Try to limit the amount of butter, mayonnaise, cheese and fried foods eaten.

Choose lower fat dairy products such as low fat yoghurts, low fat cheese and semi-skimmed milk. These will contain nearly the same amount of protein, but far less saturated fat.

NonNon-milk extrinsic sugars (NMES) naturally exist in foods such as honey and are classed as carbohydrates. As we said earlier, these are important for children and their energy levels. However, Sugar is a just a carbohydrate that provides instant energy, short bursts of energy and no other nutrients. They can also cause other problem, like gum disease and tooth decay. Non-milk extrinsic sugars are contained in jam, cakes, biscuits, sweets and fruit juice.

Sodium comes from salt. Salt is found naturally in some foods but considerable amounts are added to processed foods. Foods high in sodium include ready-made soups and sauces, some breakfast cereals, crisps, ham, pizza and fried foods. Try not to add salt whilst cooking and avoid giving processed foods to children.

So how is nutrition affected by HIV?...

Prepared for Body & Soul by Lucy Bromley March 2012Š Body & Soul 2012

HIV affects nutrition by‌ Reduces food intake- this can be due to lack of appetite from medication of illness. Tiredness and energy levels also affect the desire to consume food

HIV can cause an increase in energy requirements in children. This is because the HIV infection causes an increase in resting energy expenditure. Resting energy expenditure is the energy that your body uses for your vital organs to function.

Poor nutrient intake and absorption. This may be again due to lack of appetite but it can also be because nutrients cannot be absorbed by the body. HIV can damage the lining of the gut, which is where nutrients are absorbed into the body. This can cause them to be lost, which can eventually result in nutritional deficiencies.

Medication can also interact with nutrients. It can cause loss of nutrients within the body because of side effects.

Nutrients can also help the absorption of medication, but can also interact with some types, causing them to not work as effectively.

Prepared for Body & Soul by Lucy Bromley March 2012Š Body & Soul 2012

How can we help?

• Eating a healthy and balanced diet!

• Consuming more calories- 10% extra is needed for children with HIV • Getting involved- encouraging children to eat healthily • Encourage healthy meals and snacks without forcing • Do not use food as a reward or punishment • Lead by example…

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

Healthy eating self assessment- Are you a healthy eater?

Children learn by example, so let’s see how healthily you eat! After you’ve answered the questions we can discuss how we did as a group. Remember, there are no perfect answers, everyone likes different things!

1. You are running late and haven’t eaten breakfast yet. What do you do? a) Skip it, breakfast isn’t very important to me (2 points) b) Make two pieces of white toast with butter and jam (1 point) c) Some fruit on a bowl of muesli with skimmed milk (0 points) d) Eat a bowl of frosties with whole milk (1 point) 2. It’s time for a snack. What do you choose? a) A hot drink and a chocolate bar (1 point) b) A hot drink and two oatmeal cookies (1 point) c) A glass of water and some fruit (0 points) e) A soft drink and a packet of crisps (1 point) 3. How many portions of fruit and vegetables do you eat on a typical day?

0- 1 (2 points) 4-5 (0 point) 2-3 (1 points) 6-7 (0 point)

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

4. How many glasses of water do you drink a day?

0- 1 (2 points) 4-5 (1 point) 8-9 (0 point) 2-3 (2 points) 6-7 (0 point) 5. You’re heading for lunch with friends. What would you be most likely to choose? a) A salad with chicken and some healthy dressing (0 point) b) Pizza topped with some veg on top (1 point) d) Burger and chips (1 point) e) Salmon with green salad and cous cous (0 points) f) Jacket potato and baked beans (0 points) 8. It’s time for a treat, what do you choose? a) A piece of chocolate fudge cake (1 point) b) Homemade apple pie (0 points) c) Fresh fruit salad with yoghurt (0 points) d) Toffee ice cream sundae (1 point) e) Piece of fruit (0 points)

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

The Results

Now you’ve answered all the questions, add up your points and see which category you fit into!

0 -6 points Based on all your answers, you are eating a healthy and well balanced diet, well done!

6 -10 points Based on your answers today some areas of your diet could be improved. Don’t worry, by making some small changes now it will definitely help. Try to cut down on some of the fatty, sugary foods you are eating and make sure you increase your fruit and vegetable intake. You are nearly there, just a few more steps to a healthy diet.

1010 -50 points Based on your answers today some areas of your diet need to be improved quickly to improve your diet and help with your health. Really try to increase your intake of fruit and vegetables, make sure you’re drinking plenty of water and cut out any high fat/high sugar foods.

Once you’ve made these simple changes, you’ll be on the right track to a healthy diet!

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

Making meal times fun and playful!

Making mealtimes playful can mean healthier eating for your children. Here are some fun, creative ways to add more healthy foods to your child's diet: •Top a bowl of whole grain cereal with a smiley face: slices of banana for eyes, blueberries for nose and an apple slice for a mouth!

•Create a food forest. Use broccoli for trees, carrots for flowers, celery for grass and so on. Then you can admire your creation and eat your masterpiece!

•Make frozen fruit kebabs for kids using pineapple chunks, bananas, grapes, and berries.

•Add extra veggies to soups, stews, and sauces, grated or shredded to make them blend in.

•Keep lots of fresh fruit and veggies available as snacks. Apples, pears, bananas, grapes, carrot and celery sticks are all easy food to eat on the go.

•Go food shopping with your children. Let them see all the different fruits and vegetables and have them pick out new ones to try.

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012

So how do you encourage children to eat healthily? · Lead by example.

If your children see you eating healthily, chances are they will copy you! By being excited and interested in different and healthy foods, children can mimic you and enjoy a healthy diet! · Earlier is better.

It’s important to expose your child to healthy fruits and vegetables at a young age. Food preferences that children develop in their early years remain fairly stable and are reflected by the food choices they make in later childhood. · Be patient.

Parents who get discouraged by children not liking new foods may get frustrated after a few tries. Yet, research shows that it can take up to 12 different exposures to a new food before children will learn to accept it! Try to offer new foods often and support your child with encouraging and positive support. · Don’t restrict certain foods.

Research also shows that not allowing children to eat certain foods only makes them want it more! So help children learn that healthy foods like fruits and vegetables are “all the time foods” that they can eat anytime and enjoy! · Make healthy foods available.

As long as you keep healthy snacks like fruits and vegetables around, your child can learn to like and even choose them! · Prepare foods in healthy ways.

Small changes in the way you prepare meals and snacks can make a big difference in improving your child’s diet. For example, baking and grilling instead of frying foods can lower the fat content hugely, but still make a tasty meal! · Make it fun!

Snack and meal-time activities should be introduced colourful and playful ways. This allows children to explore the various fruits and vegetables through all of their senses. By joining in with them, you can learn and enjoy food as a family!

Do you have any tricks to share?

Prepared for Body & Soul by Lucy Bromley March 2012© Body & Soul 2012