Life Cycle Nutrition: From Infancy to Adolescence Chapter 15

What are Children Eating in the US? Too few fruits, vegetables and whole grains Too many processed foods high in added sugar, salt, and processed fats Gets worse among adolescents From NHANES,

Now vs. 25 years ago, kids eat… Less milk, fewer vegetables, eggs, and grains More cheese, fruit juices, and sweetened beverages More meals away from home Larger portion sizes More snacks

Diet-Related Disease Conditions in Children The same effects as poor diet in adults High calorie, heavily processed, nutrient-poor diets combined with sedentary lifestyle Obesity Elevated serum cholesterol Elevated blood glucose Type 2 diabetes Heart disease Hypertension

Rates of Overweight in Children and Adolescents

Mental Health Impact of Overweight and Obesity on Kids Social and psychological challenges Discrimination: –Ridicule and teasing by peers –Prejudicial treatment by adults Poor self-image, low self-esteem –Rejection –Social isolation –Contributes to continued weight issues

BMI-for-age Charts

Nutrient Needs Protein –Total amount increases with age Fat (%kcal) –Infants: 40-55% –1-3 yrs: 30-40% –4-18 yrs: 25-35% –Adults: 20-35% CHO –Same percentage as adults (45-65%) –Fiber: 14g per 1000 kcals Water –Infants: soak 6-8 diapers daily –1-3: 1.3 L/d –4-8: 1.7 L/d –Needs increase with illness, high environmental temp, or PA Micronutrients –Variety of meats, legumes, eggs, whole grains, fruits, vegetables, and dairy (if appropriate) –Deficiency risks: Calcium, Iron, Vit. A & D

Introducing Solid Foods Infants: GI tract still developing over course of first 2 years Early introduction of solids can increase risk of food allergy/sensitivity Recommended to wait until at least 4 months (6 is best) For introduction of common food allergens, waiting until at least 12 months is recommended –Cow’s milk, wheat, eggs, corn, soy –Tree nuts, seafood, peanuts

Food Allergies and Intolerances More common in infants than adults –Immature GI tract allows intact proteins to be absorbed Exposure to allergen (food protein) for first time causes immune system to produce antibodies to that allergen Allergy symptoms include coughing/wheezing, rash, eczema, hives, cramps, aches, vomiting, asthma, diarrhea, constipation, lethargy, sinus or ear infections, change in personality/behavior, rhinitis/runny or stuffy nose –Range from mild to life-threatening Allergy symptoms may be immediate or take up to 3 days to occur Montior for symptoms after each food is introduced –Introduce only one at a time! –Wait 3-5 days before adding a new one Food intolerances: problems during digestion –Not related to antibody production or proteins in food –Example: lactose intolerance

Feeding Children Development of eating habits begins in childhood –Caregivers are important guides and role models Division of responsibilities: –Caregivers decide “what and when” –Children decide “whether and how much” »Ellyn Satter, MS RD LCSW (ellynsatter.com), author of Child of Mine and Your Child’s Weight: Helping Without Harming

Meals & Snacks Good rule of thumb to offer something every 2-3 hours –Small stomachs, high energy needs Routines and consistent patterns help children to feel secure –Children may not tell you that they are hungry Sit down with kids and eat what they are eating Breakfast: very important! –Helping maintain healthy body weight –Improves performance at school –Any breakfast is better than none, but emphasizing balance among macronutrients is best

Television & Childhood Obesity TV exposes kids to food industry marketing Takes the place of physical activity Kids who watch 4 or more hours/day are 40% more likely to be overweight than those who watch an hour or less/day Computer/video games also contribute to inactivity Saturday Morning Food Ads

Weight Management in Children & Adolescents Increase activity Model healthy eating –Food choices –Eating habits –Mindfulness Provide healthy choices in the home Be very cautious if reducing intake is recommended –Avoid denying or restricting foods –Avoid any focus on appearance; focus rather on health –Instead, replace empty-calorie foods in home with nutrient-dense choices

Nutrition in Adolescence Puberty and continued organ system development –Changes in body composition –Growth rates and nutritional requirements for boys and girls diverge –Total needs greater than at any other time of life! Adolescent growth spurt: month period of rapid growth –Girls: years of age –Boys: years of age Nutritional status both during and leading up to this time affects growth and sexual maturation

Dietary Concerns with Adolescents & Teens Influence of caregivers wanes, influence of peers increases Fruits and vegetables likely to be lacking –French fries: most commonly consumed vegetable Empty-calorie snack foods –Snacks are important to meet increased caloric needs, so having healthy choices around is an important strategy Strategies for caregivers –Prepare nutrient-dense meals in the home –Engage kids in the growing and preparation of foods