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NUTRITION IN

CHILDHOOD

Nutrient requirement

Children growing & developing


need more nutritious food
May be at risk for malnutrition if :
- poor appetite for a long period
- eat a limited number of food
- dilute their diets significantly with
nutrient poor foods

Energy
Energy needs of healthy children
determined on :
- basis of basal metabolism
- rate of growth
- energy expenditure
Must be sufficient to ensure growth & spare
protein, but not so excessive
Suggested intake proportions :
50 60% carbohydrate, 25 35% fat,
10 15% protein

Daily dietary reference intakes for


energy for children
Age
(yr)
12
38
9 13

Males
(kcal)
1046
1742
2279

IOM, Food and Nutrition Board, 2002

Females
(kcal)
992
1642
2071

Protein

Early childhood 1.1 g /kg BW


Late childhood 0.95 g/kg BW
At risk for inadequate protein intake :
- strict vegan diets
- with multiple food allergies
- who have limited food selection because
of fad diets
- behavioral problems
- inadequate access to food

Daily dietary reference intakes for


protein for children
Age
(yr)
13
48
9 13

Grams

13
19
34

IOM, Food and Nutrition Board, 2002

Grams / kg

1.1
0.95
0.95

Minerals and vitamins

Necessary for normal growth & development


Insufficient intake impaired growth
deficiency disease

Iron

Children 1 3 years high risk for iron


deficiency anemia
Rapid growth period Hb & total iron
diet may not be rich in iron-containing food

Calcium

Needed for adequate mineralization &


maintenance of growing bone
DRI : 1300 mg/day 9 18 yrs
800 mg/day 4 8 yrs
500 mg/day 1 3 yrs
Primary sources : milk & dairy product
children who consumed no or limited
amount at risk for poor bone
mineralization

Zinc

Essential for growth if deficiency :


- growth failure
- poor appetite
- decreased taste acuity
- poor wound healing
RDA : 3 mg / day 1 3 yrs
5 mg / day 4 8 yrs
8 mg / day 9 13 yrs

Best sources : meats & seafood


Marginal zinc deficiency reported in
children from middle & low-income families
(Robert & Heyman, 2000)

Vitamin D

Needed for calcium absorption & deposition


calcium in the bones
The amount required from dietary sources
is depend on nondietary factors (geographic
location & time spent outside)
Primary sources : vitamin D-fortified milk

Vitamin-Mineral supplement

Do not necessarily fulfill specific nutrient needs


Children who take supplement do not
exceed the RDA
Should not take megadoses, particularly fat
soluble vitamins toxicity

Children at risk who may benefit from


supplementation :
-

from deprived families


with anorexia, poor appetites, poor eating habits
with chronic diseases (cystic fibrosis, liver dis)
enrolled in dietary programs from weight
management
- vegetarian diets with inadeq intake of dairy product
or calcium containing foods

FEEDING PRESCHOOL CHILDREN


(1 6 yrs)

Still gaining height & weight


Start to walk & talk
Depend on brain development
Depend on genetic & environmental
influences stimulation & nutrition

Marked by fast development and the


acquisition of skills
Decreased interest in food a difficult time
for parents
Smaller stomach capacity & variable
appetite small serving
Eat 4-6 x/day snacks is important
should be chosen carefully

Should not be given any food or drink within


1 hours of meal
Excessive intake of fruit juices chronic non
specific diarrhea
Excess juice intake may replace the
consumption of higher energy foods
childs appetite food intake & poor
growth
Children usually eat well in group setting
ideal environment for nutrition education
program

FEEDING SCHOOL-AGE
CHILDREN (6 - 12 yrs)

May participate in the school lunch program


or bring a lunch from home

NUTRITIONAL CONCERNS
Obesity

Increased prevalence
Not a benign condition
The longer a child has been overweight the
more likely the is to be overweight during
adolescent & adulthood
Factors contributing :
-

food establishment
eating tied to leisure activities
larger portion size
inactivity

Underweight & Failure to Thrive

Etiology :
- chronic illness
- restricted diet
- poor appetite
- feeding problems

Iron deficiency

One of the most common nutrient disorders


of childhood (9% of toddlers)
Possible factors associated : dietary intake,
parents educational level, access to medical
care
1-yr old child who consume large quantities
of milk only milk anemia
Do not like meat iron consumed in the
nonheme form

Prevention :
- consuming good dietary sources of iron
- the amount of ascorbic acid and MFP to
absorption

Dental Caries

Drink sweetened liquids from a bottle at


bedtime susceptible to early childhood
caries (Baby bottle tooth decay)
Snacks choose that are least cariogenic
Chewing sugarless gum salivary pH
beneficial
Toothbrush should be introduced

Allergies

Usually develop during infancy &


childhood and more likely when family
history (+)
Allergic responses most often include
respiratory or GI symptom & skin reaction

Autism Spectrum Disorders

Affect the childrens nutrient intake & eating


behaviors
Typically eat only specific foods
restricted diet

at risk for inadequate nutrient intake


Usually refuse fruit & vegetables
Commonly very resistant to taking supplement

Popular dietary intervention : gluten-free and


casein-free diet
Nutrition assessment should include :
- the possibility of medication and nutrient
interaction
- use of alternative therapies, herbal and
supplement
Nutrition intervention may include a
behavioral program types of food
accepted

PREVENTING CHRONIC DISEASE


Dietary fat & cardiovascular health
NCEP recommendation ( 2 yrs) :
- no more than 30% of calories from fat
( 10% SAFA, 10% PUFA, 10-15% MUFA)
- no more than 300 mg/day of cholesterol
> 2 yrs gradually adopt a lower fat diet
4 yrs meet the NCEP guidelines

Calcium & bone health

Osteoporosis prevention :
- begins in childhood by maximizing
calcium retention & bone density
- most efficient during childhood &
adolescent
Education is needed to encourage young
people to consume an appropriate amount

Fiber

Needed for health & normal laxation


Education is needed to help increase fiber
intake

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