Nutrition for Children and TeensFeeding a Healthy Young ChildAt no time in life does the human diet change faster than during the 2nd yearFrom 12-24 months, a child’s diet changes from infant foods consisting of mostly formula or breast milk to mostly modified adult foodsMilk remains a central source of calcium, protein and other nutrientsChanges in Eating Habits1-2 YearsVariable appetite and tastesTaste buds more acute than in adultsLearns to feed selfCopies othersLearns to say noFood jags love one specific food for small period of time Food neophobia scared of new food2-3 yearsCan use utensilsDevelop stronger taste preferencesCan make simple choices (ex. Between 2 fruits or vegetables, not whole meal)4-5 yearsPeers, television major influence (marketing)Appetite gradually increasingEnergy and MacronutrientsEnergyVariable, approximately 800 kcal/day for a one year oldIncreases to ~1800 kcal/day by age 10Importance of nutrient densityCarbohydratesNeeded to fuel the brainNeeds similar to adultsProteinImportant for growthPer pound, protein needs decrease as child agesDRI: 1 g/kg for ages 1-8, then decreases slightlyFatConcentrated source of energyEFAs needed for proper development of nerves, eyes and other tissues30-40% of energy for children 1-3 years of age25-35% of energy for children 4-18 years of ageMicronutrientsIronFirst food iron fortified cereal at 6 months when iron supply runs outAs children transition to unfortified foods and appetite is variable (1-2), at risk for iron deficiency anemiaFemale’s need for iron increases with menstruation, often do not get enough in their dietCalcium and Vitamin DImportant for bonesMost children get adequate calcium from milkIntake decreases as other beverages replace milkMost bone mass laid down during teenage yearsVD recommendations recently went up for all age groupsFiberDon’t have too much fiber if the child is a picky eater because it can displace caloriesDo Kids Need Supplements?Should not be needed if diet is adequate and variedMany foods (cereals) are fortified with most vitamins and mineralsFluoride if water is not fluoridated Mealtimes and SnackingThe childhood years are the parent’s last chance to influence their child’s food choicesThe parent is responsible for what the child is offered to eatThe child should decide how much and whether or not to eat itFeeding a Healthy Young ChildOffer a wide variety of healthy foodsModify as necessary (chewing, spicy foods)Keep salt and sugar to a minimumFamily mealtime is extremely important (forming habits)Modeling good habitsInvolve children/teens in cookingEvaluating Growth in ChildrenCDC Growth ChartsUpdated in 2000Gender specific, birth to 2 years and 2 to 20 yearsWeight for age, length or stature for age, head circumference for age, weight for length or stature, BMI for ageBased upon a mixture of breastfed and formula fed infantsWHO Growth StandardsApply to children from all nationsNot average growth, but how children should growBreastfed babies only Length or stature for age, weight for age, weight for height, head circumference, BMIfor 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 USUse the CDC growth charts for children ages 2-20 years and older in the USBody Changes in AdolescenceThe adolescent growth spurt increases the need for energy and nutrientsGirls’ growth spurt is from 10 and peaks at 12Boys’ growth spurt is from 12 and peaks at 14, slowing down at 19Normal gain of body fat during adolescence may be mistaken for obesity, particularly in girlsNutritional Issues for Children and TeenagersOverweight and obesity16% children 6-11 overweight (CDC)16% children aged 12-19 overweight (CDC)Too little exerciseToo many caloriesEmpty caloriesFew fruits and vegetablesBMI for Age in Children and AdolescentsLittle 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 ObesityCan lead to diseases such as Type 2 diabetes, hypertension and heart diseaseOften just slow weight-gain and let height catch upDo not want to severely limit calories while growingParents are key in providing healthy foods and teaching healthy lifestyle habits*Increase in soft drink consumption*Decrease in milk consumption*Decrease in physical activityHelping a Child/Teen lose weightProvide a well balanced dietNo extreme calorie/food restrictionMake it a family projectDon’t make them feel badEngage in physical activity as a familyInvolve child/teen in shopping/cookingNutritional Issues for Children and TeenagersFruit and vegetable intake (NHANES)Ages 2-5, only 50% met recommendations for fruit intake, 22% for vegetableAges 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 energyTop 5 sources of energy for children were grain desserts, pizza, soda, yeast breads and chicken dishesBreakfast and learningHyperactivityEating
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