Transcript Chapter 18 Life Cycle Nutrition

Chapter 18: Life Cycle Nutrition:
Childhood through Adolescence
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Toddlers versus Preschoolers

Toddlers
• 1–3 years old
• Growth rate is high, but slower than infancy
- Age 2: Gain 3–5 pounds, 3–5 inches
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Preschoolers
• 3–5 years old
• Need same nutrients as adults, but have
- Lower energy needs
- Smaller appetites
- Smaller stomachs
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Growth and Development
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Growth charts
• Used by pediatricians
- Monitor height and weight
- Compare to national standards for age and gender
- Place child in a percentile
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Growth Chart
Quick Check
Jack is 24 months
old, weighs 36
pounds and is 36
inches long.
What are his
percentiles?
Figure 18.1
Eating Patterns and Nutrient Needs
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Young children need to eat frequent, small meals and
nutrient-dense foods
• Energy needs: 1,000–1,600 kcal per day
• Appropriate portion sizes
- Child-sized plates and cups
- “Mini”-sized food items, such as bagels
- Rule of thumb is to serve 1 tablespoon of food per
year of age at a meal
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Food Safety
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Avoid choking hazards
• Offer bite-sized pieces of food
• Limit availability of
- Hot dogs
- Nuts or seeds
- Chunks of meat, cheese, or peanut butter
- Whole grapes or raisins
- Hard candy or gum
- Popcorn
- Raw vegetables
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Nutrient Needs
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Carbohydrate
• At least half of grain intake should be from whole grains
• Fiber recommendations:
- Ages 1–3 years = 19 grams
- Ages 4–8 years = 25 grams
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Nutrient Needs
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Protein
• RDA (toddlers) = 1.1 grams per kilogram of body weight
• RDA (school-age) = 0.95 grams per kilogram of body
weight
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Fat
• Ages 2–3 years old = 30–35% of kilocalories from fat
• Age 4 and over = 25–35% of kilocalories from fat
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Nutrient Needs: Calcium and Iron
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Calcium
• Necessary for healthy bone development
• Ages 1–3 years need 500 milligrams per day
- 8 ounces of milk provides 300 milligrams
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Iron
• Necessary during periods of rapid growth
• Good sources of iron for children include lean meats,
beans, and iron-fortified cereals
• Cow’s milk is a poor source of iron
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Iron: Deficiency versus Toxicity
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Deficiency (Anemia)
• Most common nutrient deficiency in young children
• Can lead to developmental delays
• Exacerbates attention deficit hyperactivity disorder
• Associated with lead poisoning
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Toxicity
• Leading cause of death in children under age 6
• Occurs because iron can build up in tissues and organs
- Ingesting 200 milligrams of iron can be fatal
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Nutrient Needs
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Vitamin D
• American Academy of Pediatrics recommends
- Ages 1–8 years consume 10 micrograms (400 IU) of
vitamin D per day
- Sources include fortified milk, egg yolk, and some fish
- Two 8-oz glasses of milk only provides half of the
recommended intake
- Supplements or fortified cereals may be needed
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Nutrient Needs
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Young children need nutrient-dense beverages
• Fluid recommendations are based on body weight
- Drinking too much fluid may reduce fiber or iron
intake
• Preferred beverages include water and milk
• 100% fruit juice can be provided in moderation
• Soda and sugary drinks should be avoided
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Food Behaviors
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Eating habits form early in life
• Children will adapt to foods offered to them
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A variety of food should be offered to young children
• A child may need to be exposed to a new food at least 10
times before accepting it
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Division of responsibility
• Parents = What, when, and where food is offered
• Child = Whether or not to eat, and how much
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“Cleaning the plate” may encourage overeating
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Food Preferences
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Parents have strong influence over children’s food
preferences
• Children model after adult behaviors, both healthy and
unhealthy
• Including young children in food shopping, menu
planning, and meal preparation can encourage variety in
their food consumption
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Food Preferences
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Picky eating and “food jags” are common in young
children
• Picky eating – not wanting to try new food
• Food jags – tendency to eat only a small selection of
food
- Very common and normal, but also temporary
- Can be identified through a food diary
- Long-term jags increase risk of nutrient deficiency
- Solutions include
- Offering a variety of food items within the
preferred food type
- Gradually weaning the child from the food item
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Vegetarianism
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Young children can grow and develop normally on a wellbalanced vegetarian diet
• Vegetarian foods such as beans, nuts, seeds, and whole
grains are high in fiber
- Multiple servings per day may exceed a young child’s
fiber needs
• Good sources of calcium, iron, and zinc need to be
included in the diet
• Supplementation of vitamin B12 may be necessary
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Quick Review
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Toddlers grow at a slower rate than infants, and have
smaller appetites
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Frequent, small meals may be needed to provide adequate
kilocalories, macronutrients, calcium, iron, and vitamin D
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Appropriate beverages include water, milk, and 100% fruit
juice
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Small portion sizes should be encouraged, while “cleaning
the plate” should be discouraged
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A variety of foods should be offered, and parents should
serve as role models for healthy eating
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“Food jags” are normal and usually temporary
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School-Aged Children
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Ages 6–12 years
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Are not fully grown
• Each year, gain about 7 pounds and 2.5 inches
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Compared to toddlers and preschoolers they
• Do not eat as many times per day
• Tend to be less hungry (maintain blood glucose longer)
• Can eat more food at each sitting
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Can impact healthy development through dietary choices
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Continue to develop habits based on modeling adult
behaviors
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Child Obesity
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Body Mass Index (BMI) is the measurement tool used to
determine weight status
• For children, the categories are
- Overweight = BMI ≥ 95th percentile
- At risk for overweight = BMI ≥ 85th percentile
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Child Obesity
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What is considered child obesity?
• Condition of a child’s having too much body weight for
his or her height.
• The use of the word “obese” to describe children is
controversial
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What causes child obesity?
• Genetics: Only a small percent of cases
• Environment: Excess kilocalories, inadequate exercise
• Obese parents
• Prenatal overnutrition
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Child Obesity: Excess Kilocalories
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Sources include
• Regular soda, candy bars, potato chips
- Many of these products are sold within school
buildings through vending machines or the cafeteria
- Also available in most convenience stores and
shopping centers
- Typically replace healthy options such as milk, water,
or fresh fruits and vegetables
• Increased portion sizes at meals and snacks
- Occurs both within and outside of the home
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Child Obesity: Food Preferences
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High sugar and high-fat foods are often preferred by
school-aged children
• This could lead to an excess kilocalorie intake
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These preferences are formed by
• Overexposure to television advertisements featuring
appealing characters or famous spokespeople
• Modeling of parent or sibling eating behavior
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Debate: Does Sugar Cause ADHD?
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Attention deficit/hyperactivity disorder (ADHD) occurs
when children are inattentive, hyperactive, and impulsive
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No cause has been identified, but a high sugar intake has
been proposed to cause hyperactive behavior
• American Dietetic Association conclusion: Sugar intake
does not have an effect on behavior or learning
• American Academy of Pediatrics conclusion: No
evidence exists that ADHD is caused by eating too much
sugar
What do you think?
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Child Obesity: Inadequate Physical
Activity
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Low levels of exercise occur in school-aged children due to
• Increased “screen time” – exposure to a television,
computer, or video games
• Less access to physical education in schools
• Increased use of a car for transportation
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Child Obesity: Prevention
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American Academy of Pediatrics recommendations
• Parents must ensure their children receive adequate
nutrients without excess kilocalories
• A variety of healthy food must be offered to children
• “Screen time” must be limited to two hours or less per
day
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Child Obesity: Treatment
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Weight loss is not recommended for overweight children
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Weight maintenance allows for healthy growth
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Increased physical activity is encouraged
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Obesity-Diabetes Relationship
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Type 2 diabetes – a disease typically diagnosed in adults
• Very likely to occur in obese children
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Prevention tips
• Identify high-risk individuals based on family history
• Reduce risk factors such as being overweight or
sedentary
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Treatment tips
• Educate all members of the family about diabetes
• Provide support by eating the same foods as the child
• Encourage physical activity
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School-Aged Children and Dental Hygiene
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42% of children and adolescents (6–19 years) have at least
one cavity or filling. Source: CDC, 2005
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School-aged children are susceptible to dental caries, but
sometimes do not practice good oral hygiene
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American Dental Association recommends
• Regular brushing and flossing
• Consuming a balanced diet in accordance with the
Dietary Guidelines for Americans
• Limiting consumption of high-sugar foods such as soda,
fruit juice, or milk
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MyPyramid for Kids
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A visual tool for children and parents to understand healthy
eating
Figure 18.3
MyPyramid for Kids
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Key messages
• Be physically active every day
• Choose healthier foods from each group
• Eat more of some food groups than others
• Eat foods from every food group every day
• Make the right choices for you
• Take it one step at a time
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National School Lunch Program (NSLP)
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Serves nutritious, low-cost or free lunches to 30.5 million
school-aged children each day
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NSLP nutrient guidelines have specific recommendations
establishing
• Minimum intakes
• Maximum intakes
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The Role of Breakfast
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Eating breakfast may be associated with healthy body
weight among children and adolescents
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Many schools with the National School Lunch Program
also offer a school breakfast
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Eating breakfast may benefit
• Cognitive function, including memory
• Academic performance
• School attendance
• Psychosocial function
• Mood
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Quick Review
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Rates of overweight and obesity are increasing among
school-aged children
Risk of type 2 diabetes increases in obese individuals
Limiting excess kilocalorie intake from high-sugar or highfat foods can help prevent obesity
Engaging in physical activity and reducing “screen time” is
necessary to maintain a healthy body weight
MyPyramid for Kids provides information about healthy
eating patterns
Schools may provide nutritious breakfast and lunch meals
Parents must continue to serve as role models for healthy
behavior
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Adolescence

Developmental period between childhood and adulthood
• Ages 9–19 years
• Physical changes occur, including a growth spurt
- Height increases
- Weight increases due to bone growth and gains in lean
body mass and body fat stores
• Hormonal changes occur including the onset of
menstruation for females
• A healthy diet is necessary at this time to ensure
adequate nutrients, especially kilocalories, protein,
calcium, and iron
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Nutrition-Related Behaviors
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Desire for independence and individuality
• Making own food choices
• Having own transportation to access food
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Influence of peers, media, and nonparent role models
• Exposure to unrealistic or unsafe eating practices
• May lead to adoption of damaging habits
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Nutrient Needs: Calcium
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½ of peak bone mass
accumulates in adolescence
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AI for calcium = 1,300 mg
for ages 9–18 years
• Inadequate calcium
intake can lead to low
peak bone mass and is a
risk factor for
osteoporosis
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Figure 18.4
Nutrient Needs: Iron
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Additional iron supports muscle growth and increased
blood volume
• Adolescent females need iron to support menstruation
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RDA for iron
• Females aged 14–18 years = 15 milligrams
• Males aged 14–18 years = 11 milligrams
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Iron deficiency is common in adolescence, especially
among individuals who limit intake of enriched grains, lean
meats, and legumes
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Disordered Eating
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Disordered eating patterns are more prevalent in adolescent
females than males
• May be linked with poor body image or low self-esteem
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Teens often adopt unhealthy habits such as
• Skipping meals
• Using food substitutes
• Taking diet pills or nutritional supplements
• Purging through vomiting, laxatives, or diuretics
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Eating family meals promotes healthy eating patterns
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Quick Review
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Height and weight increase during the growth spurt in
adolescence
• This prompts an increased need for calcium and iron
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Adolescents have increased power over their food decisions
• Soda and sports drinks may replace water and milk
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Peers and the media exert a strong influence on teens
• As a result, unhealthy habits may be formed
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Disordered eating may exist in teens with poor body image
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Putting It All Together
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Toddlers and preschoolers benefit from eating frequent,
small meals consisting of nutrient-dense meals
Exposure to a variety of healthy foods is necessary to
promote good nutrition
Picky eating and “food jags” are common, temporary
behaviors
In childhood, obesity may result from overconsumption of
kilocalories, especially in the form of soda or candy
Parents can serve as good role models by choosing healthy
foods for themselves at family meals
Adolescence is characterized by a growth spurt which
increases calcium and iron needs
A teenager’s eating habits may be influenced by peers or
the media
© 2010 Pearson Education, Inc.