Nutritional requirements 21 may 16

© 2010 Pearson Education, Inc.

Life Cycle Nutrition: Childhood through Adolescence


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 Preschoolers

• 3–5 years old• Need same nutrients as adults, but have

- Lower energy needs- Smaller appetites- Smaller stomachs


Growth and Development Growth charts

• Used by pediatricians- Monitor height and weight- Compare to national standards for age and gender- Place child in a percentile


Eating Patterns and Nutrient Needs 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


Food Safety 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


Nutrient Needs 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


Nutrient Needs Protein

• RDA (toddlers) = 1.1 grams per kilogram of body weight• RDA (school-age) = 0.95 grams per kilogram of body

weight Fat

• Ages 2–3 years old = 30–35% of kilocalories from fat• Age 4 and over = 25–35% of kilocalories from fat


Nutrient Needs: Calcium and Iron Calcium

• Necessary for healthy bone development• Ages 1–3 years need 500 milligrams per day

- 8 ounces of milk provides 300 milligrams 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


Iron: Deficiency versus Toxicity Deficiency (Anemia)

• Most common nutrient deficiency in young children• Can lead to developmental delays• Exacerbates attention deficit hyperactivity disorder• Associated with lead poisoning

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


Nutrient Needs 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


Nutrient Needs 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


Food Behaviors Eating habits form early in life

• Children will adapt to foods offered to them 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

Division of responsibility• Parents = What, when, and where food is offered• Child = Whether or not to eat, and how much

“Cleaning the plate” may encourage overeating


Food Preferences 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


Food Preferences 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


Vegetarianism Young children can grow and develop normally on a well-

balanced 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


Quick Review Toddlers grow at a slower rate than infants, and have

smaller appetites Frequent, small meals may be needed to provide adequate

kilocalories, macronutrients, calcium, iron, and vitamin D Appropriate beverages include water, milk, and 100% fruit

juice Small portion sizes should be encouraged, while “cleaning

the plate” should be discouraged A variety of foods should be offered, and parents should

serve as role models for healthy eating “Food jags” are normal and usually temporary


School-Aged Children Ages 6–12 years Are not fully grown

• Each year, gain about 7 pounds and 2.5 inches 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

Can impact healthy development through dietary choices Continue to develop habits based on modeling adult

behaviors


Child Obesity 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


Child Obesity 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

What causes child obesity?• Genetics: Only a small percent of cases• Environment: Excess kilocalories, inadequate exercise• Obese parents• Prenatal overnutrition


Child Obesity: Excess Kilocalories 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


Child Obesity: Food Preferences High sugar and high-fat foods are often preferred by

school-aged children• This could lead to an excess kilocalorie intake

These preferences are formed by• Overexposure to television advertisements featuring

appealing characters or famous spokespeople• Modeling of parent or sibling eating behavior


Debate: Does Sugar Cause ADHD? Attention deficit/hyperactivity disorder (ADHD) occurs

when children are inattentive, hyperactive, and impulsive 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?


Child Obesity: Inadequate Physical Activity 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


Child Obesity: Prevention 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


Child Obesity: Treatment Weight loss is not recommended for overweight children Weight maintenance allows for healthy growth Increased physical activity is encouraged


Obesity-Diabetes Relationship Type 2 diabetes – a disease typically diagnosed in adults

• Very likely to occur in obese children Prevention tips

• Identify high-risk individuals based on family history• Reduce risk factors such as being overweight or

sedentary Treatment tips

• Educate all members of the family about diabetes• Provide support by eating the same foods as the child• Encourage physical activity


School-Aged Children and Dental Hygiene 42% of children and adolescents (6–19 years) have at least

one cavity or filling. Source: CDC, 2005 School-aged children are susceptible to dental caries, but

sometimes do not practice good oral hygiene 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

Figure 18.3

MyPyramid for Kids

A visual tool for children and parents to understand healthy eating


MyPyramid for Kids 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


National School Lunch Program (NSLP) Serves nutritious, low-cost or free lunches to 30.5 million

school-aged children each day NSLP nutrient guidelines have specific recommendations

establishing• Minimum intakes• Maximum intakes


The Role of Breakfast Eating breakfast may be associated with healthy body

weight among children and adolescents Many schools with the National School Lunch Program

also offer a school breakfast Eating breakfast may benefit

• Cognitive function, including memory• Academic performance• School attendance• Psychosocial function• Mood


Quick Review 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 high-

fat 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


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


Nutrition-Related Behaviors Desire for independence and individuality

• Making own food choices• Having own transportation to access food

Influence of peers, media, and nonparent role models• Exposure to unrealistic or unsafe eating practices• May lead to adoption of damaging habits

© 2010 Pearson Education, Inc. Figure 18.4

Nutrient Needs: Calcium ½ of peak bone mass

accumulates in adolescence 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


Nutrient Needs: Iron Additional iron supports muscle growth and increased

blood volume• Adolescent females need iron to support menstruation

RDA for iron• Females aged 14–18 years = 15 milligrams• Males aged 14–18 years = 11 milligrams

Iron deficiency is common in adolescence, especially among individuals who limit intake of enriched grains, lean meats, and legumes


Disordered Eating Disordered eating patterns are more prevalent in adolescent

females than males• May be linked with poor body image or low self-esteem

Teens often adopt unhealthy habits such as• Skipping meals• Using food substitutes• Taking diet pills or nutritional supplements• Purging through vomiting, laxatives, or diuretics

Eating family meals promotes healthy eating patterns

Nutritional requirements 21 may 16

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