Feeding a Healthy Young ChildAt no time in life does the human diet change faster than during the second yearFrom 12 to 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 adultslearned to feed selfcopies otherslearns to say nofood jagsfood neophobia2 – 3 yearscan use utensilsdevelop stronger taste preferencecan make simple choices4 – 5 yearspeers, television major influence (marketing)appetite gradually increasingEnergy and MacronutrientsEnergyVariable, approximately 800 kcal/day for a one year oldIncreases to approx. 1800 kcal/day by age 10Importance of nutrient densityCarbohydratesNeeded to fuel the brainNeeds similar to adultsProteinImportance for growthPer pound, protein needs decrease as child agesDRI: 1.0 g/kg for ages 1-8 then decreases slightlyFatConcentrated source of energyEFAs needed for proper development of nerves, eyes and other tissues30 to 40 percent of energy for children age 1 to 3 years of age25 to 35 of energy for children 4 to 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 (age 1-2) at risk for iron deficiency anemiafemales’ need for iron increases with menstruation, often do not get enough in their dietCalcium and Vitamin DImportant for bonesMost children get adequate calcium form milkIntake decreases as milk is replaced by other beveragesMost bone mass laid down during teenage yearsVD recommendations recently went up for all age groupsFiberAge ---------fiber1-3 ---------194-8 ---------259-13 boys----319-13 girls ---2614-18 boys---3814-18 girls ---26Do kids need supplements?Should not be needed if diet is adequate and variedMany foods (cereals) are fortified with most vitamins and mineralFluoride if water is not fluoridatedMealtimes and SnackingThe childhood years are the parents’ 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 even whether to eatFeeding a Healthy Young ChildOffer a wide variety of healthy foodsModify as necessary (chewing, spicy foods)Keep salt, sugar to a minimumFamily mealtime extremely important (forming habits)Model good habitsInvolve children/ teens in cookingEvaulating 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 mixture for breastfed and formula fed infantsWHO Growth StandardsApply to children from all nationsNot average growth, but how children should growBreastfed 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 othersWhich growth charts to use?CDC recommends that health care providers:Use the WHO growth standards to monitor growth for infants and children ages 0 to 2 years of age in the USUse the CDC growth charts for children age 2 years and older in the USAge specific b/c body fat percentage changes with age (CDC)Gender specific b/c body fat percentage varies according to gender (CDC)Body Changes in AdolescenceThe adolescent growth spurt increases the need for energy and nutrientsGirls growth spurt if from 10 and peaks at 12 yearsBoys growth spurt is from 12 and peaks at 14 years, slowing down at 19The normal gain of body fat during adolescence may be mistake for obesity , particularly in girlsChildhood ObesityCan lead to diseases such as type 2 diabetes, hypertension and heart diseaseIn a study, 70% of obese children had at least 1 additional CVD factor, and 30% had 2 or moreOften just slow weight gain and let height catch upDo not want severe caloric restriction while growingParents are key in providing healthy foods and teaching healthy lifestyle habitsNutritional issues for children and teenagersOverweight and obesityToo little exerciseToo many caloriesEmpty caloriesFew fruits and vegetablesHelping a Child or Teen to Lose WeightProvide a well balance dietNo extreme calorie/food restrictionMake it a family projectDon't make children/teen feel bad about his/her weightEngage in physical activity as a familyInvolved child/teen in shopping/cookingNutritional Issues for Children and TeenagersFruit and vegetables intakes (NHANES)Ages 2-5 only 50% met recommendations for fruit intake, 22% for vegetablesAges 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 10% of total energytop 5 sources of energy for children were grain desserts, pizza, soda, yeast breads, and chicken dishesbreakfast and learninghyperactivityeating disordersNutrition and AgingPhysiological changesChanges in nutrient needsFactors affecting food choicesPrograms for the elderlyAging is individualisticSuccessful agers: no chronic diseases, functional independenceGoals: maintain health and prevent diseaseElderly HealthUsual agers: 1 or more chronic diseases , some disability but can functionGoal: percent disabilitiesAccelerated agers: physical function has declined , dementiaGoal: maintain functional status and increase independenceFactors that determine how you ageGeneticsLifestyle habitsDietExerciseAlcohol. SmokingAdequate, regular sleepmaintaining healthy weightMajor causes of disabilitySarcopeniaLoss of skeletal muscle and strength associated with aging (.5-1% loss per year after the age of 25) leads to frailtyOsteoporosis (see below)ArthritisDeterioration in and around jointsLeading cause of disability and painCommon among obese individualsImproved through exercise and weight lossNutrition ??Heart disease and cognitive dysfunctionNutrients involved ??FolateVitamin b12 and b6Homocysteine??Psychological Changes with ageBody compositionDecreased lean body massLean body mass during young adulthood is 45% of total body weightLean body mass decrease to 27% of total body weight in older adulthoodConsequences of decrease LBMWeakened response to illness or other stressDecreased mobilityInstability fallsDecreased bone mineral densityBone mass is gained
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