Nutrition for Children and Teens Feeding a Healthy Young Child At no time in life does the human diet change faster than during the 2nd year From 12 24 months a child s diet changes from infant foods consisting of mostly formula or breast milk to mostly modified adult foods Milk remains a central source of calcium protein and other nutrients Changes in Eating Habits 1 2 Years Variable appetite and tastes Taste buds more acute than in adults Learns to feed self Copies others Learns to say no Food jags love one specific food for small period of time Food neophobia scared of new food 2 3 years 4 5 years Can use utensils Develop stronger taste preferences Can make simple choices ex Between 2 fruits or vegetables not whole meal Peers television major influence marketing Appetite gradually increasing Energy and Macronutrients Energy Variable approximately 800 kcal day for a one year old Increases to 1800 kcal day by age 10 Importance of nutrient density Carbohydrates Needed to fuel the brain Needs similar to adults Protein Fat Important for growth Per pound protein needs decrease as child ages DRI 1 g kg for ages 1 8 then decreases slightly Concentrated source of energy EFAs needed for proper development of nerves eyes and other tissues 30 40 of energy for children 1 3 years of age 25 35 of energy for children 4 18 years of age Micronutrients Iron First food iron fortified cereal at 6 months when iron supply runs out As children transition to unfortified foods and appetite is variable 1 2 at risk for iron deficiency anemia Female s need for iron increases with menstruation often do not get enough in their diet Calcium and Vitamin D Important for bones Most children get adequate calcium from milk Intake decreases as other beverages replace milk Most bone mass laid down during teenage years VD recommendations recently went up for all age groups Fiber Don t have too much fiber if the child is a picky eater because it can displace calories Do Kids Need Supplements Should not be needed if diet is adequate and varied Many foods cereals are fortified with most vitamins and minerals Fluoride if water is not fluoridated Mealtimes and Snacking The childhood years are the parent s last chance to influence their child s food choices The parent is responsible for what the child is offered to eat The child should decide how much and whether or not to eat it Feeding a Healthy Young Child Offer a wide variety of healthy foods Modify as necessary chewing spicy foods Keep salt and sugar to a minimum Family mealtime is extremely important forming habits Modeling good habits Involve children teens in cooking Evaluating Growth in Children CDC Growth Charts Updated in 2000 Gender specific birth to 2 years and 2 to 20 years Weight for age length or stature for age head circumference for age weight for length or stature BMI for age Based upon a mixture of breastfed and formula fed infants WHO Growth Standards Apply to children from all nations Not average growth but how children should grow Breastfed babies only Length or stature for age weight for age weight for height head circumference BMI for age etc Which Growth Charts to Use CDC recommends that health care providers Use the WHO growth standards to monitor growth for infants and children ages 0 2 years of age in the US Use the CDC growth charts for children ages 2 20 years and older in the US Body Changes in Adolescence The adolescent growth spurt increases the need for energy and nutrients Girls growth spurt is from 10 and peaks at 12 Boys growth spurt is from 12 and peaks at 14 slowing down at 19 Normal gain of body fat during adolescence may be mistaken for obesity particularly in girls Nutritional Issues for Children and Teenagers Overweight and obesity 16 children 6 11 overweight CDC 16 children aged 12 19 overweight CDC Too little exercise Too many calories Empty calories Few fruits and vegetables BMI for Age in Children and Adolescents Little date to connect BMI values in adolescence and their relations with current or future risk or response to interventions de Onis and Habicht Age specific because body fat percentage changes with age CDC Gender specific because body fat percentage varies according to gender CDC Childhood Obesity Can lead to diseases such as Type 2 diabetes hypertension and heart disease Often just slow weight gain and let height catch up Do not want to severely limit calories while growing Parents are key in providing healthy foods and teaching healthy lifestyle habits Increase in soft drink consumption Decrease in milk consumption Decrease in physical activity Helping a Child Teen lose weight Provide a well balanced diet No extreme calorie food restriction Make it a family project Don t make them feel bad Engage in physical activity as a family Involve child teen in shopping cooking Nutritional Issues for Children and Teenagers Fruit and vegetable intake NHANES Ages 2 5 only 50 met recommendations for fruit intake 22 for vegetable Ages 6 11 only 26 16 Ages 12 18 only 20 11 Empty Calories NCI 40 of children s total calories coming from empty calories recommended 8 20 Sugar sweetened beverages contributing to 10 of total energy Top 5 sources of energy for children were grain desserts pizza soda yeast breads and chicken dishes Breakfast and learning Hyperactivity Eating disorders
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