10 24 2012 Feeding a Healthy Young Child At no time in life does the human diet change faster than during the From 12 to 24 months a child s diet changes from infant foods consisting of mostly formula or breast milk to mostly modified adult o Milk remains a central source of calcium Protein and other second year foods nutrients Changes in eating habits 1 2 years o variable appetite and tastes o taste buds more acute than in adults o learned to feed self o copies others o learns to say no o food jags o food neophobia 2 3 years 4 5 years o can use utensils o develop stronger taste preference o can make simple choices o peers television major influence marketing o appetite gradually increasing Energy and Macronutrients Energy o Variable approximately 800 kcal day for a one year old o Increases to approx 1800 kcal day by age 10 o Importance of nutrient density Carbohydrates o Needed to fuel the brain o Needs similar to adults Protein o Importance for growth o Per pound protein needs decrease as child ages o DRI 1 0 g kg for ages 1 8 then decreases slightly Fat o Concentrated source of energy o EFAs needed for proper development of nerves eyes and other tissues o 30 to 40 percent of energy for children age 1 to 3 years of age o 25 to 35 of energy for children 4 to 18 years of age Micronutrients iron o first food iron fortified cereal at 6 months when iron supply runs out o as children transition to unfortified foods and appetite is variable age 1 2 at risk for iron deficiency anemia o females need for iron increases with menstruation often do not get enough in their diet Calcium and Vitamin D o Important for bones o Most children get adequate calcium form milk o Intake decreases as milk is replaced by other beverages o Most bone mass laid down during teenage years o VD recommendations recently went up for all age groups Fiber o Age fiber o 1 3 19 o 4 8 25 o 9 13 boys 31 o 9 13 girls 26 o 14 18 boys 38 o 14 18 girls 26 o o Do kids need supplements Should not be needed if diet is adequate and varied Many foods cereals are fortified with most vitamins and mineral Fluoride if water is not fluoridated Mealtimes and Snacking child s food choices The childhood years are the parents last chance to influence their The parent is responsible for what the child is offered to eat The child should decide how much and even whether to eat Feeding a Healthy Young Child Offer a wide variety of healthy foods o Modify as necessary chewing spicy foods Keep salt sugar to a minimum Family mealtime extremely important forming habits Model good habits Involve children teens in cooking Evaulating Growth in Children CDC Growth Charts o Updated in 2000 o Gender specific birth to 2 years and 2 to 20 years o Weight for age length or stature for age head circumference for age weight for length or stature BMI for age o Based upon mixture for 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 based on data form brazil hong kong Netherlands Singapore UK US Length or stature for age weight for age weight for height head circumference and BMI for age and many others Which growth charts to use CDC recommends that health care providers o Use the WHO growth standards to monitor growth for infants and children ages 0 to 2 years of age in the US o Use the CDC growth charts for children age 2 years and older o Age specific b c body fat percentage changes with age CDC o Gender specific b c body fat percentage varies according to in the US gender CDC Body Changes in Adolescence The adolescent growth spurt increases the need for energy and nutrients down at 19 o Girls growth spurt if from 10 and peaks at 12 years o Boys growth spurt is from 12 and peaks at 14 years slowing The normal gain of body fat during adolescence may be mistake for obesity particularly in girls Childhood Obesity heart disease Can lead to diseases such as type 2 diabetes hypertension and In a study 70 of obese children had at least 1 additional CVD factor and 30 had 2 or more Often just slow weight gain and let height catch up o Do not want severe caloric restriction while growing Parents are key in providing healthy foods and teaching healthy lifestyle habits Nutritional issues for children and teenagers Overweight and obesity o Too little exercise o Too many calories o Empty calories o Few fruits and vegetables Helping a Child or Teen to Lose Weight Provide a well balance diet No extreme calorie food restriction Make it a family project Don t make children teen feel bad about his her weight Engage in physical activity as a family Involved child teen in shopping cooking Nutritional Issues for Children and Teenagers Fruit and vegetables intakes NHANES o Ages 2 5 only 50 met recommendations for fruit intake 22 for vegetables o Ages 6 11 only 26 16 o Ages 12 18 only 20 11 Empty Calories NCI o 40 of children s total calories coming from empty calories recommended 8 20 o sugar sweetened beverages contributing 10 of total energy o top 5 sources of energy for children were grain desserts pizza soda yeast breads and chicken dishes breakfast and learning hyperactivity eating disorders 10 24 2012 Nutrition and Aging Physiological changes Changes in nutrient needs Factors affecting food choices Programs for the elderly Aging is individualistic Successful agers no chronic diseases functional independence Goals maintain health and prevent disease Elderly Health function Usual agers 1 or more chronic diseases some disability but can Goal percent disabilities Accelerated agers physical function has declined dementia o Goal maintain functional status and increase independence Factors that determine how you age Genetics Lifestyle habits o Diet o Exercise o Alcohol Smoking o Adequate regular sleep o maintaining healthy weight Major causes of disability Sarcopenia o Loss of skeletal muscle and strength associated with aging 5 1 loss per year after the age of 25 leads to frailty Osteoporosis see below Arthritis o Deterioration in and around joints o Leading cause of disability and pain o Common among obese individuals o Improved through exercise and weight loss o Nutrition o Heart disease and cognitive dysfunction o Nutrients involved Folate Vitamin b12 and b6 o Homocysteine Psychological Changes with age Body composition o Decreased lean body mass Lean body mass during young adulthood is 45 of total body weight Lean body mass decrease to 27 of total body weight in
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