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7/27/2019 K.25 Nutrition in Childhood
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NUTRITION IN
CHILDHOOD
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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
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Energy
Energy needs of healthy childrendetermined 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
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Daily dietary reference intakes forenergy for children
Age Males Females
(yr) (kcal) (kcal)
1 2 1046 992
3 8 1742 1642
9 13 2279 2071
IOM, Food and Nutrition Board, 2002
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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
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Daily dietary reference intakes forprotein for children
Age Grams Grams / kg
(yr)
1 3 13 1.1
4 8 19 0.95
9 13 34 0.95
IOM, Food and Nutrition Board, 2002
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Minerals and vitamins
Necessary for normal growth & development Insufficient intake impaired growth
deficiency disease
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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
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Calcium
Needed for adequate mineralization &maintenance of growing bone
DRI : 1300 mg/day 9 18 yrs800 mg/day 4 8 yrs
500 mg/day 1 3 yrs
Primary sources : milk & dairy product children who consumed no or limitedamountat risk for poor bonemineralization
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Zinc
Essential for growth if deficiency :
- growth failure
- poor appetite- decreased taste acuity
- poor wound healing
RDA : 3 mg / day 1 3 yrs5 mg / day 4 8 yrs
8 mg / day 9 13 yrs
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Best sources : meats & seafood
Marginal zinc deficiency reported in
children from middle & low-income families(Robert & Heyman, 2000)
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Vitamin D
Needed for calcium absorption & deposition
calcium in the bones The amount required from dietary sources
is depend on nondietary factors (geographiclocation & time spent outside)
Primary sources : vitamin D-fortified milk
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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
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Children at risk who may benefit fromsupplementation :
- 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
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FEEDING PRESCHOOL CHILDREN(1 6 yrs)
Still gaining height & weight
Start to walk & talk
Depend on brain development
Depend on genetic & environmentalinfluences stimulation & nutrition
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Marked by vast development and theacquisition of skills
Decreased interest in food a difficult timefor parents
Smaller stomach capacity & variableappetite small serving
Eat 4-6 x/day snacks is importantshould be chosen carefully
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Should not be given any food or drink within1 hours of meal
Excessive intake of fruit juices chronic non
specific diarrhea Excess juice intakemay replace the
consumption of higher energy foodschilds appetite food intake & poor
growth Children usually eat well in group setting
ideal environment for nutrition educationprogram
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May participate in the school lunch programor bring a lunch from home
FEEDING SCHOOL-AGECHILDREN (6 - 12 yrs)
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NUTRITIONAL CONCERNS
Obesity Increased prevalence Not a benign condition
The longer a child has been overweight
themore likely the is to be overweight duringadolescent & adulthood
Factors contributing :
- food establishment
- eating tied to leisure activities
- larger portion size
- inactivity
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Underweight & Failure to Thrive
Etiology :
- chronic illness
- restricted diet- poor appetite
- feeding problems
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Iron deficiency
One of the most common nutrient disordersof childhood (9% of toddlers)
Possible factors associated : dietary intake,parents educational level, access to medicalcare
1-yr old child who consume large quantities
of milk only
milk anemia Do not like meat iron consumed in the
nonheme form
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Prevention :
- consuming good dietary sources of iron
- the amount of ascorbic acid and MFP to absorption
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Dental Caries
Drink sweetened liquids from a bottle atbedtime susceptible to early childhood
caries (Baby bottle tooth decay) Snacks choose that are least cariogenic
Chewing sugarless gum salivary pHbeneficial
Toothbrush should be introduced
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Allergies
Usually develop during infancy &childhood and more likely when family
history (+) Allergic responses most often include
respiratory or GI symptom & skin reaction
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Autism Spectrum Disorders
Affect the childrens nutrient intake & eatingbehaviors
Typically eat only specific foods
restricted diet
at risk for inadequate nutrient intake
Usually refuse fruit & vegetables
Commonly very resistant to taking supplement
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Popular dietary intervention : gluten-free andcasein-free diet
Nutrition assessment should include :
- the possibility of medication and nutrientinteraction
- use of alternative therapies, herbal and
supplement
Nutrition intervention may include abehavioral program types of foodaccepted
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PREVENTING CHRONIC DISEASEDietary 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 diet4 yrs meet the NCEP guidelines
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Calcium & bone health
Osteoporosis prevention :
- begins in childhood by maximizing
calcium retention & bone density- most efficient during childhood &
adolescent
Education is needed to encourage youngpeople to consume an appropriate amount
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Fiber
Needed for health & normal laxation
Education is needed to help increase fiber
intake
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