Chapter 14

V. Chan, MS, RD

Feeding a Healthy Young Child

Rapid changes during second year

Dietary

changes

Breast milk/ formula to modified/ solid foods Malnourished child at age 3 impairs brain development

Growth

& body composition

Generally get taller and losses body fat

Appetite regulation
Fluctuation

of appetite

Regulation of treats
Children who have regularly timed, varied snacks/ meals, with only occasional special treats, often gain weight appropriately and grow normally

Feeding a Healthy Young Child

Energy
Needs

vary widely

Growth

and physical activity

Vegan

diets

Protein
Needs Vegetarian

diets

Feeding a Healthy Young Child

Carbohydrate and fiber

Glucose use by the brain Fiber recommendations

Derive from adult recommendations Adjust amount for picky eaters or those who eat very little

Fat and fatty acids

DRI recommendations Vitamin D

Vitamins and minerals

Many children eat below recommended amount (10 micrograms)

Consider supplement

Iron

Important to incorporate iron rich foods

Prevent over consumption of milk, as if displaces meats and enriched grains

Meal Times and Snacking

Adopting healthy habits/ attitudes towards foods

Implications Fruits

for adulthood

Current U.S. childrens food intakes

and vegetables
Take in too much Na & fat

French fries & bananas are commonly consumed Low in fiber intake

Vitamins

and minerals

Low in Vit E, calcium, magnesium, potassium

Childrens preferences
Flavors Bribing

and temperatures

Meal Times and Snacking

Treats vs. dinner

Problems with a lot of treats Food neophobia

Fear of new foods

Offer multiple times, especially when the child is hungry Children need to see their parents/ guardians consume

Child preferences vs. parental authority

Children are entitled to their own likes/ dislikes

But should not allow them to dictate their diet

Tend to pick high fat, sugary and salty foods

Avoid clean you plate rules

Teaches children to void their satiety feeling What is the adult caregivers responsibility How much & whether should be the childs choice

What, how much, and whether

Meal Times and Snacking

Snacking

Teach how to snack To make better choices

Restaurant choices
(ex) split a regular meal among several children (ex) request water, fat- free milk or fruit juice (not punch) for beverages

Important for parents to make healthy choices to set examples for children Sit when eating to avoid choking Caution with potential choking foods (including grapes, nuts, hard candies, tough meat pieces, popcorn) Include children in food preparation

Choking

Food skills

Pride and positive feelings

How Nutrient Deficiencies Can Impair a Childs Brain

Physical and behavioral symptoms Iron deficiency

Intellectual

performance

Attention span shortens

Key

problem among U.S. children

Iron toxicity
Supplements

An RD or physician should make decision if a supplement is necessary

Problem of Lead

High concentration levels

Mental, behavioral, and other health problems

Once in the body, not easy to excrete

Sources
Old

paint, water from old pipes, certain pieces of metal, etc

Absorb 5-10 times as much toxin as adults

Problem of Lead

Harm from lead

Lead

builds up silently in the body

Symptoms may not be noticeable until much later Effects may not be reversible

Academic

skills Hearing impairment Other health effects

Kidneys Nerves Brain Other organs Can lead to death

Problem of Lead

Lead and nutrient interactions

Malnutrition

and lead poisoning

Children absorb more lead on empty stomachs Deficiencies in calcium, zinc, vitamin C, vitamin D, or iron

Modifications in U.S. environment

Decline

in average blood level concentrations

Low levels can still cause damage on growing children

Food Allergy, Intolerance & Aversion

Food allergy
Prevalence

Adults and children

Peanut allergy growing 20% children grow out of it

True

food allergen triggers an immune response to antigen

Antibodies and histamine

Anaphylactic

shock

Life threatening allergic reaction Epinephrine- hormone to open airways, maintain heartbeat and blood pressure

Food Allergy, Intolerance & Aversion

Allergen Food

ingestion
invisible traces

Hidden/

labels

Cross-contamination Eight

common culprits requiring labels

Food Allergy, Intolerance & Aversion

Detecting an allergy Components Always involve antibodies Sometimes involve symptoms Reaction time Some are immediate Some take a 24 hour period Food intolerance No immune response Food aversion Intense dislike for food Biological and psychological response

Diet & Hyperactivity

Attention-deficit/hyperactivity disorder (ADHD)

Affect

5-10% young children Characteristics

Chronic inability to pay attention Trouble learning Poor impulse control

Impacts

on child

Lead to academic failure Cause behavior problems

ADHD and food allergies

No

correlation, more studies need to be proven

Sugar and behavior

According

to scientists, sugar do not cause hyperactivity/ behavioral problems

Physical Activity, TV & Childrens Nutrition Problems

Activity of U.S. children has declined

Recommended

maximum TV and screen

time: 2 hours

Often exceeded, longer times often associated with obesity

Television and nutrients

Low

energy requirements Time taken away for active play time Between-meal snacking increase is more likely Less likely to consume fruits/ vegetables

Dental Caries

Affected by the majority of the population of a country

Half

of the affected majority experienced by age 2

Fluoridation of drinking water Development of dental caries Dental disease

Bacteria

can travel via bloodstream to other tissue, including the heart which may cause heart disease

Food and caries

Thrive on carbohydrates Beverages can erode enamel

Importance of Breakfast

Supports growth and development

Cannot

make up for losses

Detriments of not eating breakfast U.S. government breakfast program

Benefits

of these meals

How Nourishing are School Meals?

National School Lunch program

USDA-regulated

meals Benefits of consuming meals from these programs

Mandates for districts

Local

wellness policy to establish:

Nutrition edu, physical activity Nutrition guidelines Measure implementation

Challenge to implement

Competitive foods

Nutrition in Adolescence

Teenager food choices

Primary influences

Consuming meals with family may increase fruits/ veg/ fiber intake

The adolescent growth spurt

Girls: 10- 11 years old, peaks at 12 Boys: 12-13 years old, peaks at 14 Wide variations

Energy needs and physical activity

Generally boys need more calories than girls

15% age 6-19 years old are overweight Usually by age 15, physical activity decreases/ diminishes Different from standards for adults

Weight status and body fatness

Use of growth charts

Girls develop more fat than men Eating disorders may develop during adolescence

Nutrient Needs

Most during adolescence

With exception of pregnancy and lactation

Vitamins Iron

and minerals

Muscle mass, menstruation Needs increase during growth spurt Iron deficiency common among girls Essential for bone growth Soda displaces calcium rich beverages 50% of adolescents may be deficient Supplement recommended for those that do not meet needs

Calcium

Vitamin D

Common Concerns

Menstruation

Premenstrual syndrome (PMS)

Nutrition: energy metabolism, vitamin D, vitamin B6, and calcium Scientists believe 2 weeks prior to menstruation, BMR speed up during sleep and appetite increase (esp for carb and/ or fat rich foods) Belief that increase of Vit B6 may lessen symptoms of PMS

More studies need to be done Long term use of high dose supplement may be harmful

Calcium & Vit D may improve symptoms of PMS

Acne

Factors influencing development

Psychological stress, hormones No specific food has been proven to cause acne

False beliefs

Eating Patterns and Nutrient Intake

During adolescence, food habits change for the worse

Common

nutritional behaviors

Role of adults
Gatekeeper

Set example Provide healthy food items Teachable moments

Specific nutrients to help with skin Calories in fast food items

Snacks

The Later Years

Adopt healthy nutritional behaviors early on will enhance health as we get older

Characteristics of healthy aging people

Nonsmokers -Abstain drinking alcohol/ drink moderately Maintain healthy body weight -Physically Active Positive attitude -Well nourished

Life expectancy

The graying of America

Average person may live to almost 78 years Health-related behaviors Genetics

Life span

Believed to be 130 years

Scientists believe that there is no specific diet/ nutrient supplement to increase longevity

Nutrition in the Later Years

Needs become more individual with age Energy recommendations

Often

decrease with age Benefits of physical activity and nutritious diet

Keeping mentally sharp
Body

mass index training

Physical activity
Resistance

Prevent some muscle loss

Nutrition in the Later Years

Protein needs
DRI

recommendations

Same for elderly and young adults

Acceptable for elderly to have a little more Better to choice low fat sources

Sources

Carbohydrates and fiber

Sources Benefits

of adequate fiber in ones

diet

Nutrition in the Later Years

Fats and arthritis

Types

of fats consumed

Essential fatty acids Saturated fat Associated with being overweight

Osteoarthritis

Rheumatoid

arthritis

Immune system malfunction

Attacks its own immune system Vit C may worsen symptoms Caution with supplements that are advertised to help cure arthritis or provide relief

Supplements

Nutrition in the Later Years

Vitamin needs

Absorption generally decreases as we get older Absorption increases as we get older

Vitamin A

Low dosage of Vit A not recommended

Vitamin D

Synthesis declines as we get older

Very easily for deficiency to develop

Vitamin B12

Amount needed as we age

Stomach acid reduced

Other vitamins and phytochemicals

Vitamin E- immune system, mental functions, eyesight as we age Carotenoids- correlation with eye protection, may prevent macular degeneration Vitamin C

Foods high in Vit E, carotenoids & Vit C may prevent cataracts Vit C supplements may increase risk of cataracts

Nutrition in the Later Years

Water and minerals

Water

Dehydration may be confused with senile dementia Dehydration may also cause bedridden patients to develop pressure sores

Recommend to drink 6 cups of fluid/ day

Iron

Anemia

Contributing factor includes poor appetite Poor iron absorption due to reduced stomach acid Antacid use Medication causing blood loss

Other factors contribute to deficiency

Zinc

Immune function and appetite Absorption declines Multivitamin may be beneficial

Calcium

Supplements

Can Nutrition Help People Live Longer?

Factors

affecting physiological age

Alcohol

use Nutritious meals Weight control Sleep Smoking Physical activity

Health Concerns & Aging

Immunity and inflammation

Chronic

diseases

Nutrient deficiencies, sedentary lifestyle, malnutrition, and antibiotics Free-radical hypothesis

Alzheimers disease
Genetics Characteristics Nutritional

links

No real connection Not enough studies on whether supplements may help or worsen

Food Choices of Older Adults

Obstacles to adequacy
Living

situation Medications and alcohol

Programs that help

SNAP Meals

on Wheels