|
|
 |
|
|
|
|
| a |
| |
TIPS
ON CHILD AND ADOLESCENT NUTRITION
|
| |
|
|
|
What
are the most important nutritional considerations
in the first year of life?
In
the first 12 months of life a baby will
triple its weight and increase its length
by 50 per cent. These gains in weight and
height are the primary indices of nutritional
status and their accurate measure at regular
intervals are compared with standard growth
charts. These measurements are important
tools for monitoring a child's progress
particularly during the first 6 to 12 months
of life.
Breast-feeding
on demand remains the ideal form of feeding
for healthy babies who are born at term.
Human milk provides optimum nutritional
needs for growth and development. The first
4-6 months are a period of very rapid growth,
particularly for the brain, and the amino
acid and fatty acid composition of breast
milk is ideally suited to meet those needs.
Breast milk also contains anti-bacterial
and anti-infection agents, including immunoglobulins,
which have an important role to play in
boosting immune function. The colostrum,
which is the fluid produced by the mammary
gland during the first few days after birth,
is rich in protein and has high levels of
minerals and vitamins. Colostrum also contains
antibodies, anti-infection agents, anti-inflammatory
factors, growth factors, enzymes and hormones,
which are beneficial for growth and development.
Breast-feeding
is strongly advocated for physiological,
psychological and emotional reasons. There
is no reason why breast-feeding should not
continue for as long as it is nutritionally
satisfactory for mother and child up to
2 years. However, with changing lifestyles
and the availability of commercially prepared
formulae, prepared formulae is generally
safe provided that an approved infant formula
is used under strict hygienic conditions.
Formula-fed infants also need to be demand
fed and the formulae must be made up exactly
according to the manufacturer's instructions
for optimal growth. Special attention has
to be taken to sterilise all the feeding
equipment to reduce the potential risk of
contamination, because formula-fed babies
do not have the same degree of immunological
protection as breast-fed babies.
|
| |
Top
|
|
|
When should solid
foods be introduced?
|
|
|
|
|
|
Introduction
of complementary solid food is usually a
gradual process over several weeks or months,
starting at about 6 months of age. The exact
timing is determined by the individual infant
and mother, and reflects the fact that breast
milk will suffice in those first months
but will no longer be able to provide adequate
nutrition by itself as the baby grows. The
introduction of complementary foods by about
6 months is important to ensure normal chewing
and speech development The quality, number
and variety of solid feeds can be increased
gradually at a pace that will be generally
dictated by the child. Cereals are generally
the first foods that are introduced into
the infant's diet (mixed with a little breast
milk or formula), with purées of vegetables
and fruits to follow. By exclusive breast
feeding up to 4 to 6 months of age, the
likelihood of allergies is lessened.
An
important consideration in the first year
of life is the amount of iron supplied in
the diet and iron deficiency anaemia is
routinely screened for during infancy. The
use of an iron-fortified formula or cereal,
and the provision of iron-rich foods can
help to prevent this problem.
|
| |
Top
|
| |
|
|
|
What
are the most important nutritional considerations
for toddlers (1-3 years of age)?
During
these years, a child begins to take on its
own unique personality and to exert its
independence by moving around freely and
choosing foods to eat. Although the child
is still growing, the rate of growth is
slower than in the first 12 months of life.
At the end of the third year of age, girls
and boys will have achieved about 50 per
cent of their adult height.
During
this period a child becomes able to drink
through a straw and eat with a spoon, and
frequently they become "fussy" eaters. The
provision of a variety of foods will allow
the child to choose from a range of foods
with differing tastes, textures, and colours
to help satisfy their small appetites. The
most important factor is to meet energy
needs with a wide variety of foods.
Food
intake will be influenced increasingly by
family eating patterns and peers. Early
food experiences may have important effects
on food likes and dislikes and eating patterns
in later life. Meal times should not be
rushed and a relaxed approach to feeding
will pave the way for healthy attitudes
to food.
|
| |
Top
|
|
|
|
|
|
What
are the most important nutritional considerations
in school-aged children?
|
|
|
|
|
|
After
4 years of age, a child's energy needs per
kilogram of bodyweight are decreasing but
the actual amount of energy (calories) required
increases as the child gets older. From
5 years to adolescence, there is a period
of slow but steady growth. Dietary intakes
of some children may be less than recommended
for iron, calcium, vitamins A and D and
vitamin C, although in most cases -as long
as the energy and protein intakes are adequate
and a variety of foods, including fruit
and vegetables, are eaten- deficiencies
are unlikely.
Regular
meals and healthy snacks that include carbohydrate-rich
foods, fruits and vegetables, dairy products,
eggs, legumes and nuts should contribute
to proper growth and development without
supplying excessive energy to the diet
Children
need to drink plenty of fluids, especially
if it is hot or they are physically active.
Water is obviously a good source of liquid
and supplies fluid without calories. Variety
is important in children's diets and other
sources of fluid such as milk and milk drinks,
fruit juices and soft drinks can also be
chosen to provide needed fluids
|
|
|
Top
|
| |
|
|
|
What
are the most important nutritional considerations
for adolescents?
|
|
|
|
|
|
The
nutritional requirements of young people
are influenced primarily by the spurt of
growth that occurs at puberty. The peak
of growth is generally between 11 and 15
years for girls and 13 and 16 years for
boys. The nutrient needs of individual teenagers
differ greatly, and food intake can vary
enormously from day to day, so that those
with deficient or excessive intakes on one
day may well compensate on the next. In
this period of life, several nutrients are
at greater deficiency risk including iron
and calcium.
|
|
|
|
|
Iron
Among
adolescents, iron-deficiency anaemia
is one of the most common diet-related
deficiency diseases.
Adolescents
are particularly susceptible to iron
deficiency anaemia in view of their
increased blood volume and muscle
mass during growth and development.
This raises the need of iron for building
up haemoglobin, the red pigment in
blood that carries oxygen, and for
the related protein myoglobin, in
muscle. The increase in lean body
mass (LBM), composed mainly of muscle,
is more important in adolescent boys
than in girls. In preadolescent years,
LBM is about the same for both sexes.
Once adolescence starts, however,
the boy undergoes a more rapid accumulation
of LBM for each additional kilogram
of body weight gained during growth,
ending up with a final LBM maximum
value double that of the girl. Other
factors contributing to elevated iron
needs are increased body weight and
the beginning of menstruation for
girls. All these factors should be
taken into account when assessing
iron needs in this group of age
One
of the most important diet considerations
during adolescence is an increase
in the intake of iron-rich foods such
as beans, dark green vegetables, nuts
and iron-fortified cereals and other
grains. However, Iron from animal
foods such as lean meats and fish
(known as haem iron) is much better
absorbed than iron from non-animal
sources (non-haem iron).
|
| |
|
|
|
Top
|
|
|
Calcium
The
skeleton accounts for at least 99%
of the body stores of calcium and
the gain in skeletal weight is most
rapid during the adolescent growth
spurt. About 45% of the adult skeletal
mass is formed during adolescence,
although its growth continues well
beyond the adolescent period and into
the third decade. All the calcium
for the growth of the skeleton must
be derived from the diet. The largest
gains are made in early adolescence,
between about 10-14 years in girls
and 12-16 years in boys.
During
peak adolescent growth, calcium retention
is, on average, about 200mg/day in
girls and 300 mg/day in boys. The
efficiency of calcium absorption is
only around 30% so it is important
that the diet supplies an adequate
calcium intake to help build the densest
bones possible The achievement of
peak bone mass during childhood and
adolescence is crucial to reduce the
risk of osteoporosis in later years.
By eating several servings of dairy
products, such as milk, dahi
and cheese, the recommended calcium
intake can be achieved.
As
well as a good dietary supply of calcium,
other vitamins or minerals, like vitamin
D and phosphorous, are needed for
building up bones. Physical activity
is also essential, particularly weight-bearing
exercise, which provides the stimulus
to build and retain bone in the body.
Activities such as cycling, gymnastics,
skating, ball games, dancing and supervised
weight training for at least 30-60
minutes a day, three to five times
a week can help build bone mass and
density.
|
|
|
|
| |
Top
|
|
|
Food
habits: why are regular eating patterns
and snacks important?
Dietary
habits, which affect food preferences,
energy consumption and nutrient intakes,
are generally developed in early childhood
and particularly during adolescence.
The home and school environments play
a major role in determining a child's
attitude to, and consumption of individual
foods
Teenagers,
as well as being exposed to periodic
food fads and slimming trends, tend
to skip meals and develop irregular
eating habits. One of the most frequently
missed meals is breakfast. Studies
show that breakfast plays an important
role in providing needed energy and
nutrients after an overnight fast
and can aid in concentration and performance
at school.
Snacks
generally form an integral part of
meal patterns for both children and
teenagers. Younger children cannot
eat large quantities at one sitting
and often get hungry long before the
next regular mealtime. Mid-morning
and mid-afternoon snacks can help
to meet energy needs throughout the
day. Fast-growing and active teenagers
often have substantial energy and
nutrition needs and the teaching of
food and nutrition in the school curricula
will enable children to have the knowledge
to make informed choices about the
foods in their regular meals and snacks.
|
| |
|
|
|
Top
|
|
|
Energy
needs
|
|
|
|
|
|
Normally,
the energy requirements of adolescents
tend to parallel their growth rate,
and individuals assess their energy
needs by means of their appetite with
remarkable precision. As a result,
the majority of adolescents maintain
energy balance, and a varied food
intake provides sufficient nutrients
to ensure optimal growth and development.
Stress
and emotional upsets however can seriously
affect the energy balance in adolescents,
resulting in the consumption of too
little or too much food. Mild or severe
infections, nervousness, menstrual,
dental or skin problems (acne) can
result in depression of appetite,
and those adolescents on marginal
diets are the most vulnerable. Emotional
stress is often associated with food
faddism and slimming trends, both
of which can lead to eating disorders
such as anorexia nervosa.
Lack
of activity plays an important role
in the development, progression and
perpetuation of obesity in adolescence.
Physical inactivity does not only
have a prime role in the development
of overweight and obesity, but also
on the development of chronic diseases
such as heart disease, certain cancers,
diabetes, hypertension, bowel problems
and osteoporosis in later life. In
addition, physical activity is related
to improvements in body flexibility,
balance, agility and co-ordination
and strengthening of bones. It is
recommended that children be physically
active for at least 60 minutes daily.
|
|
|
a |
|
|
|
|
|
 |
|
|
|
|
