> **[Strong Bones for Life]{.underline}**
>
>  
>
> **Who:**  WIC parents and their children
>
> **Why:**  To encourage parents to help children establish good eating
> and exercise habits
>
> **When:**  Designated class times (20-30 minutes in length)
>
> **Where:**  SCHD auditorium or SCHD library, Richland Outreach, Live
> Oak Outreach
>
> **What:**  Prevention of disease/obesity due to lack of adequate
> calcium in the diet.
>
> **What for:  (by the end of the class participants will have)**
>
> 1.      Listened why bone health is important.
>
> 2.      Viewed graphic of the skeletal system.
>
> 3.      Listed food sources of calcium.
>
> 4.      Listed habits that deplete bones of calcium.
>
> 5.      Listened to the association between calcium intake and weight
> maintenance.
>
>  
>
> **How:**  Flip Charts with lists of main points
>
> blank flip chart, white board or chalk board to write down
> participants' answers
>
> sharpies or other markers
>
> **Props:**  Play dough for making figures of human body.
>
> Human Body Skeletal System graphic (source Trend enterprises, Inc.). 
>  
>
> Short question & answer session at end of presentation for parents and
> kids.
>
> **Room set up** so that participants have space to jump especially the
> children.
>
>  
>
> **Handouts:** calcium foods coloring pages for kids
>
>                    calcium rich snack ideas for grown-ups & kids
>
>                     
>
> **Incentive:**  Prop 10 parent kits which includes child's toothbrush.
>
>  
>
> **Introduction: **
>
> Good morning/afternoon.  My name is \_\_\_\_\_\_\_\_\_\_\_.  We are
> going to talk about keeping you and your child healthy today.  Please
> feel free to ask questions or make comments during the presentation. 
> The information contained in this class are general recommendations. 
> If you have any doubts about your child's health or your own, please
> call your healthcare provider.
>
>  
>
> Welcome to our class about calcium intake and healthy bones.
>
> **Intake Lags Behind\
> **Our children's intake of calcium is lagging behind the current
> intake recommendations. Food surveys show that few youngsters take in
> enough calcium to maximize their lifetime bone development. At a time
> when they need calcium the most, kids are choosing soft drinks and
> other drinks over dairy products. While recent government
> recommendations advise a calcium intake of 800 milligrams for 4-8
> year-olds, nutrition surveys show a decline in calcium intake for this
> age group, with fewer than half consuming the recommended amount each
> day.  The current recommendation for ages 1-3 is 500 milligrams of
> calcium which is equal to 3 servings of calcium-rich foods each day.
>
> **Task 1 (10 minutes)**
>
> **\[Parents and Kids activity.\]** So let's talk about how we can
> build healthy bones.  I'm going to give everyone some play dough. 
> Please make a stick figure of a person.  Parents help out!  (Have
> graphic of skeletal system on easel for discussion coming.)  So I'll
> give you a couple of minutes to make your play dough person. 
> (Presenter should have a play dough person ready or make one while
> audience is doing theirs.)  When everyone is finished ask the
> audience:  Do you think your play dough person has a skeleton? (Some
> will say yes.) Demonstrate smashing your play dough person. 
> Narrative: If the figure had a skeleton and you tried to squash the
> figure it should not have flattened.  Since the figure can be
> squashed, it has no skeleton.   What are your questions?
>
>  
>
> **Did you know... ( have these points ready on a flip chart and
> discuss with audience)**
>
> our bones are mainly composed of calcium 
>
> (narrative:  Calcium is the mineral in your body that makes up your
> bones and keeps them strong.  Most of the calcium in your body is
> stored in your bones and teeth.  Without calcium you wouldn't be able
> to stand up!  We would be a glob of jelly like a jelly fish)
>
> we have 206 bones in our bodies?  Wow, that's a lot!
>
> 26 of those bones are in the foot
>
> (for kids...Can everyone point to your foot?)
>
> we are born with 22 bones make up our skull and protect our brains
>
> (for kids...Can everyone point to your head?)
>
>  
>
> **What do you know about your bones?**  (Pause 3-5 seconds for
> discussion)  Great!  Here are some more interesting things to know
> about your bones.
>
>  
>
> **Did you know...**
>
> Your body starts to form most of your bone mass when you are a child.
>
> "Bone bank"  (narrative:  Think of your bones like a bank account
> with deposits and withdrawals.  For children there are many more
> deposits than withdrawals.  The more deposits that are made while
> young, the stronger the bones will be as they get older.)
>
> The maximum amount of bone or peak bone mass is reached around age 30
> for women and around age 35 for men.  (narrative:  After this age
> there is no more opportunity for bone building.  The bone you have
> built is what you have for your lifetime.)    ** **
>
>  
>
> What are your questions?
>
>  
>
> **Task 2 (10 minutes)**
>
> **What do you know about keeping our bones healthy?**  
>
> (Pause 3-5 seconds for any discussion.  Write any answers on flip
> chart or chalk board)
>
> Those were great answers. 
>
>  
>
> Eat 3 a day  (narrative:  Make sure to eat at least 3 calcium rich
> foods everyday!  Calcium rich foods include milk, cottage cheese, and
> calcium fortified juices.  Have these calcium rich foods on hand for a
> healthy snack.  Give example of serving sizes.)
>
>  
>
> **[bone building foods ]{.underline}   **(have ready on flip
> chart)** **
>
> cheese cubes/string cheese
>
> calcium fortified juices
>
> single serving puddings
>
> individual cheese pizzas
>
> yogurt and frozen yogurt
>
> broccoli with yogurt dip
>
>  
>
> Do bone building activities daily. What are some examples of some
> bone building activities you do daily? (Pause 3-5 seconds for
> discussion).
>
>  
>
> For the kids and grown-ups, too, if they want, jump up and down. 
> (Class presenter should jump, too.)  This is one of the best ways to
> keep your bones healthy.  Jumping up and down is good for your bones
> it helps them stay strong.  Similar to what lifting weights does for
> your muscles.  Other bone building activities are: 
>
>  
>
> **[bone building activities]{.underline}**    [(have ready on flip
> chart)]{.underline}
>
> running
>
> walking
>
> dancing
>
> basketball
>
> weight lifting
>
> jumping rope
>
> skateboarding
>
> soccer
>
> hopping
>
>  
>
> What are your questions?
>
>  
>
> **More habits for healthy bones are: ** (Have flip chart with this
> list ready) 
>
> Get enough vitamin D in your diet  (narrative:  Your body can make
> its own vitamin D.  A few minutes in the sun every other day is
> adequate.  Vitamin D is also in egg yolks and fortified milk.) 
>
> Talk to your doctor about bone health (narrative:  You doctor will
> review your family's health history and make suggestions for good bone
> health.  In some cases, your doctor may suggest a bone density test or
> suggest medication to prevent porous bones \[osteoporosis\].)
>
> Be a good role model.  (Kids learn what they see, not what they
> hear.  If you get out and exercise, eat healthy foods and avoid
> smoking and alcohol, so will your kids.)
>
>  
>
> **What things do you think you should avoid to promote healthy
> bones?**  (Pause 3-5 seconds for any answers and write on flip chart
> or chalk board)
>
>  
>
> **Things to avoid for healthy bones are:**
>
> Don't smoke, don't start.  (narrative:  smoking is toxic to our bones
> and inhibits absorption of calcium into our bones.)
>
> Avoid excessive alcohol (narrative:  Excessive is defined as more
> than 1 drink per day for women and 2 for men)
>
> Limit caffeine  (narrative:  too much caffeine can increase shedding
> of calcium reserves out into urine.)
>
> Limit access to sodas  (Don't keep sodas in the house.  Milk, water,
> smoothies or calcium fortified juices are better choices and are good
> for bone health.  Phosphates which are in sodas inhibit calcium
> absorption.)
>
> Establish time limits for TV watching, being on the computer, and
> video game playing.  (These activities are associated with childhood
> obesity as well as not being good for bone health.  Our kids need more
> activity time and less time sitting!)
>
>  
>
> What are your questions?
>
>  
>
> **Why are healthy bones important?  Why are we bothering to talk about
> bone health in such detail? ** (Pause 3-5 seconds for answers.)
>
> The skeleton allows humans to stand, sit, run, roll, walk, and perform
> almost every other motion!  When bones aren't healthy a person may
> live in pain and it may be very easy to break them.
>
>  
>
> **Task 3 (10 minutes)**
>
> **Is anyone here unable to drink milk or eat dairy products due to
> lactose intolerance or milk allergy?  Maybe you just don't like to
> drink milk or eat dairy products?** (Only cover this if someone in the
> class is lactose intolerant or has some aversion to dairy products.)
>
>  
>
> **Short definition of lactose intolerance (only say if needed). **
> This is the inability to digest the sugar in milk.  Symptoms are gas,
> diarrhea, cramps and bloating after eating some type of dairy product.
>
>  
>
> **There are other sources of calcium besides dairy products.  Anyone
> have ideas about what some of** **those foods may be?**  Pause 3-5
> seconds for ideas.
>
>  
>
> **[Non-dairy sources of calcium]{.underline}** (listed on flip chart)
>
> calcium fortified juices 
>
> tofu
>
> fortified cereal such as Total
>
> almonds
>
> calcium fortified soy milk
>
> collard greens
>
> dried figs
>
> broccoli
>
> spinach
>
> salmon
>
> canned sardines
>
>  
>
> **Has anyone heard about the calcium connection to weight
> maintenance?**
>
> How can a mineral used by the body to build strong bones possibly have
> a role in weight control? Even scientists have been scratching their
> heads in response to this observation in recent years. But the
> relationship appears to be a real one. As early as preschool age,
> researchers have observed that higher calcium intakes and more dairy
> servings/day are associated with lower body fat. In one study, an
> extra serving of dairy resulted in about 2 pounds less body fat in the
> children.
>
> Studies with adults have shown a similar trend.  A number of studies
> that were designed to look at the relationship of calcium and bone
> health were reanalyzed to see if calcium affected body weight. In one
> study, it was found that for every 300 milligram increase in calcium
> intake, adults had 5.5 -- 7 pounds less body weight. It was concluded
> that "improving the calcium intake of the U.S. population has the
> potential to effect a substantial reduction in the prevalence of
> obesity."
>
> **What if calcium supplementation is needed for an adult?**  The best
> way to get your calcium is from foods, but if you fall short of your
> daily calcium recommendation on a regular basis or your doctor
> suggests supplementation, here are some important things to know:     
>
> break up the dose into 500 mg per doses for best absorption  
>
> Do not use calcium supplements from called coral calcium, bone meal,
> oyster shell, all "natural"  (risk of contamination of lead or other
> heavy metals)  
>
> Good, cheap source calcium carbonate ( may cause constipation,
> absorption is not optimal)...Tums, Viactiv, Rolaids 
>
> calcium citrate offers good absorption no constipation (Citracal is
> one brand)
>
>  
>
> **Why do adults need calcium if most bone is built by age 30-35?**
>
> Adults need calcium everyday just like children because you need to
> maintain your calcium "pool".  If your body does not have enough
> calcium for everyday bodily functions from the diet, the calcium
> needed will be taken from the bone making the bones weaken.  If you do
> not get enough calcium, you may have muscle cramps in your hands and
> feet.   You may also develop osteoporosis, which may result in:
>
> a gradual loss of height
>
> humping of the back
>
> bones that break easily
>
> serious fractures if you fall.
>
>  
>
> What are your questions about today's class?
>
>  
>
> questions for kids....
>
> What nutrient is in milk and cheese that you should have for healthy
> teeth and bones?
>
> What part of the body does the skull provide protection for?
>
>  
>
> questions for adults...
>
> Who can name two non-dairy calcium foods?
>
> Who would like to share their favorite family food that is a good
> source of calcium?
>
>  
>
> Thank you for attending today's class. You may keep your playdough!
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> Sutter County WIC June 2004
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