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Thursday, December 18, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


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Group photo of Suquamish Head Start students holding up delicious raw Brussels sprouts. Suquamish Head Start students think Brussels sprouts are so delicious, some ate them raw, right after this photo was taken.

Health for Native Life, Number 11, Special Youth Edition

Turning "Yuck!" to "Yum!"

Suquamish Head Start shows it’s as easy as counting to five!
Turning brussels sprouts. They’re the granddaddy of vegetables–packed with nutrition, but having a strong, unique flavor. If kids will eat brussels sprouts, chances are they will eat a wide variety of vegetables.

At the Suquamish Tribe in Washington State, Head Start students are Brussels sprouts savvy. Ask the morning class how many like the green veggie, and half the children quickly raise their hands. Every child has had the green globes sitting on their plates. Every child has been asked to try a bite. And almost all have eaten at least a bite or two.

Photo of head cook Teri Bayes (Suquamish) holding slices of kiwi. Head cook Teri Bayes (Suquamish) says it’s easy to introduce new foods to children because of the “no-thank-you bite” rule.

Starting with the youngest
It has not always been like this. Three years ago, staff members decided to take action to change eating habits of community members. “There was a high number of adults and children who were overweight,” says nutritionist Fran Miller. Being overweight made both groups at higher risk for getting diabetes.

Fran and other staff decided to first target three- to five-year-old children. “Preschool-age children are open to everything,” explains Fran. “By elementary school, children are still open to new foods, but they have already developed specific likes and dislikes.” Fran and Head Start staff joined forces and changed the Head Start menu.

Out with sweets, in with veggies and fruits
Changes were made right away. Juices and desserts were dropped from the menu, replaced with water and 1% milk. Sugar-filled desserts were changed to slices of kiwi or handfuls of grapes. Frozen, prepared foods were replaced with fresh, low-fat meats and whole grains.

Even the birthday party treats were changed. Instead of cupcakes, head cook Teri Bayes (Suquamish) began making popcorn, homemade blueberry muffins and sugar-free Jell-O®. Instead of plates of cookies, parents were encouraged to bring in gifts of stickers or sheets of brightly colored paper.

And with every lunch, green, yellow, red, purple, and white veggies and fruits appeared.

Photo of Koh-Kai Williams and Tyler
Marquez (both Suquamish) eating their favorite food - cabbage. Sometimes peer-pressure is a good thing. Koh-Kai Williams shows Tyler Marquez (both Suquamish) that cabbage is a favorite food of many.

Kids like green!
But did they eat it? The answer was, and still is, “Yes!” Half the Head Start children say they love Brussels sprouts. And guess what their favorite vegetable is… broccoli!

And, what do you think these youngsters say when they are shown a picture of a spinach salad? “Yum!”

Going from “Yuck!” to “Yum!” doesn’t just happen. These are not super-Brusselssprouts-eating-kids from the Northwest. The Suquamish Head Start children are like all other children. They have seen the fast-food TV commercials. They have probably eaten many chicken nuggets in dipping sauce. They used to think those nuggets were tasty. Now, many prefer garlic chicken sautéed in olive oil. How did that happen?

What kids really want
Fran says she started with her belief that a lot of healthy foods are delicious. Children naturally want to eat delicious foods. They want to be healthy and feel good. Her motto is, “Let the children try it.” Teri says Fran’s belief that children are eager to try new things helped her change what she cooks. “I love to see the kids love the good food.” So Teri jumped right in, ordering lean meats, and slicing and dicing fruits and vegetables. She says that now, “The smell of garlic is a sign. It tells the children there is something delicious for lunch. When they smell something good, they are eager to eat it.” Deep-fried chicken nuggets don’t have a chance compared to the aroma of garlic sautéed chicken breast.

Photo of Tleena Ives (Port Gamble S’Klallam / Suquamish) reading “Tricky Treats” to Max Dawes and Joshua George. Tleena Ives (Port Gamble S’Klallam / Suquamish) reads “Tricky Treats” to Max Dawes and Joshua George. The boys learn about “sometimes foods:” donuts, candy, cookies, and chips. And they learn about “everyday foods:” berries, oranges, apples, broccoli, and carrots.

Learning to love it
Of course, you can’t go from one day serving burgers with tater tots, to the next day serving baked salmon with sautéed purple cabbage, and expect kids to gobble it up. If you did that, you would surely hear the “Yuck!” word. So, while cook Teri was slowly adding more fruits and vegetables, Head Start lead teachers Micki Andrews (Cherokee) and Candace Chapman (Cherokee/Choctaw), were working with Fran to teach the children about “Yum!” foods. While eating lunch with the children, they would scoop up a forkful of cabbage, eat it and said, “Yum! I LOVE cabbage.”

When the children drank water, Micki, Candace, and other teachers began to say, “That water is helping your AMAZING BODY.” When the kids looked at pictures of donuts and cookies, teachers taught them to call them “sometimes foods.” At the same time, fruits, vegetables, and low-fat foods became “everyday foods.” Broccoli became “edible trees.” Children learned that candy is infested with “sugar bugs,” a major “Yuck!”

Eating rainbows
To help the kids keep trying new foods, teachers made Taste Books. Every time a new food was served, teachers wrote down the name of the food and the child’s reaction. If the child did not eat the food, he/she was given one stamp. If the child tried the food, two stamps. If the food was eaten with gusto, there were stamps all over the page.

A new rule was put in place. Children could not refuse a food. They were required to at least put the food on their plate. The next time the food was served, they were asked to take a “no, thank you bite.” Micki encouraged them by saying, “How do you know you don’t like it if you won’t try it?”

Photo of bigger-than-life super hero Captain Five-a-Day
Captain Five-a-Day and the fruit-and-veggie beanies teach Head Start kids about healthy foods. “I have an amazing body!”

Fran became “Captain Five-a-Day,” a bigger-than-life super hero. She taught the children to eat at least five fruits and vegetables each day. The teachers chimed in, “Eat a rainbow of fruits and vegetables each day.”

With the changes in words, came a change in thoughts, a change in behavior, and then a change in habits. Here’s proof: Ask four-year-old Kiaya Natrall what her favorite foods are. “Carrots, broccoli, blueberries, and pineapple,” she says.

Health-smart kids
This group of Head Start children has had two years of nutrition education. They easily eat spinach salad and steamed zucchini. They can easily talk about why they want to eat healthy foods: “Eating fruits and vegetables keeps us healthy and strong,” says one girl.

“Eating the five groups makes you healthy!” says one boy.

“I have an amazing body!” says another.

Amazing! The teachers encourage the children to look at themselves in the mirror, to flex their muscles, to admire their good health. “See what five-a-day does for your body!” says Micki. The children stand up tall and smile big at their reflections. They ARE amazing.

Which Will Win?

Chicken Nuggets versus Garlic Sautéed Chicken Breast

Garlic Sauteed Chicken Breast

TRY THIS TASTE TEST:
Eat one chicken nugget without dipping sauce. Then, eat a piece of skinless, garlic sautéed chicken breast. No cheating. No dipping sauce. Eat the pieces slowly and really taste them. Which tastes better?

Suquamish Head Start cook Teri Bayes says chicken nuggets flunk the test. “We’ve been brainwashed to think a chicken nugget is more delicious than sautéed chicken. And we think nuggets are healthy because there is chicken in them. But you have to eat a lot of the breaded part before you get to the benefit of the protein.”

Teri also knows that most people need that dipping sauce to disguise the blandness of the nuggets. However, garlic sautéed chicken breast doesn’t need sauce and can be eaten as is–without sauce, without guilt, and with the knowledge that these breadless, sauceless tidbits are a great source of protein.

- Compare -

Chicken Nuggets and Dipping Sauce

(about 5 ounces, with 2 packets of barbecue sauce)

Garlic Sautéed Chicken Breast

(one breast, with garlic and a teaspoon of olive oil)

  • 520 calories
  • 24 grams of fat
  • 5 grams of saturated fat
  • 119 milligrams of cholesterol
  • 1120 milligrams of sodium
  • 50 grams of carbohydrate
  • 15 grams of protein
  • 271 calories
  • 10 grams of fat
  • 2 grams of saturated fat
  • 73 milligrams of cholesterol
  • 0 milligrams of sodium
  • 0 grams of carbohydrate
  • 43 grams of protein

For more information, or to contribute a story idea, contact:

Cecilia Kayano, Kayano Design/Write, Inc.
Tel: (360) 273-6501
e-mail: kayanodesign@aol.com

- or -

IHS Division of Diabetes Treatment and Prevention
5300 Homestead Rd. NE
Albuquerque, NM 87110
Tel: (505) 248-4182; Fax: (505) 248-4188
e-mail: diabetesprogram@ihs.gov

*IHS wants to share the information found in Health for Native Life magazine. Articles may be reprinted.
Please include the statement: "Reprinted from IHS Health for Native Life Magazine."

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Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov