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Chapter 11 Nutrition Through the Life-Span: Childhood & Adolescence © 2007 Thomson - Wadsworth Early & Middle Childhood • After age 1 growth rate slows • Body continues to change rapidly • Bones grow longer; muscles gain size & strength © 2007 Thomson - Wadsworth Energy & Nutrient Needs • Children’s appetites Decline markedly around the first birthday Thereafter, they fluctuate Food energy intakes vary from meal to meal Daily energy remains constant • Energy Kcal needs depend on growth & activity • 1 year = 800/day • 6 years = 1600/day • 10 years = 2000/day 9 million children over age 6 are obese Vegans may have trouble meeting energy needs © 2007 Thomson - Wadsworth Early & Middle Childhood • Nutrients • Food Patterns Are steadily increased Important to accumulate stores of nutrients before adolescence Influences nutritional health for a lifetime Variety of foods from each food group Increased calcium & fiber © 2007 Thomson - Wadsworth My Pyramid for Children © 2007 Thomson - Wadsworth Children’s Food Choices • Need to be nutritious & appealing • Limit candy, cola, & other concentrated sweets Nutrient deficiencies Obesity • Underweight children can have higher kcalorie foods Ice cream, pudding, whole wheat or enriched crackers or pancakes © 2007 Thomson - Wadsworth Malnutrition in Children • Prevalent in verylow-income families • 13 million children are food insecure • WIC, School Breakfast & National School Lunch Program help • Effects of hunger Short term • Short attention span • Irritable • Apathetic & uninterested Long term • Impaired growth & immune system © 2007 Thomson - Wadsworth Hunger & School Performance • Children who eat breakfast function better • No breakfast More overweight Poorer concentration Shorter attention span Lower test scores Tardy or absent more often • Child must eat every 4-6 hours to maintain blood glucose • Liver cannot store more than 4 hours worth of glycogen • Low blood glucose © 2007 Thomson - Wadsworth Iron Deficiency • Deficiency and behavior • Prevention Energy crisis Affects mood, attention span, & learning ability More conduct disturbances Affects brain before anemia develops Need 7-10 mg/day Milk intakes must be limited after infancy Eat lean meats, fish, poultry, eggs, & legumes Also whole-grain or enriched breads & cereals © 2007 Thomson - Wadsworth Other Nutrient Deficiencies • Any other missing or deficient nutrients can cause behavioral & physical symptoms Irritable, aggressive, disagreeable, sad or withdrawn Labeled hyperactive, depressed, or unlikable © 2007 Thomson - Wadsworth Lead Poisoning in Children • Can cause an iron deficiency • Mild toxicity Diarrhea, irritability, anemia, & fatigue • Severe toxicity Irreversible nerve damage, paralysis, mental retardation, death © 2007 Thomson - Wadsworth Food Allergies • Only 6% of children • Diminishes with age • Whole food protein or large molecule enters the body & acts like an antigen • Antibodies are produced • Food intolerance Does not involve the immune system © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth Food Allergies • Asymptomatic & symptomatic allergies May produce antibodies & have no symptoms If no antibodies it is not an allergy • Symptoms Nausea & vomiting (GI) Rashes (skin) Inflammation or asthma (nasal passages & lungs) Anaphylactic shock (all body systems) © 2007 Thomson - Wadsworth Food Allergies • Immediate & • Symptoms of delayed reactions anaphylactic shock can occur Tingling in mouth, swelling of tongue & • Anaphylactic shock Peanuts, tree nuts, milk, eggs, wheat, soybeans, fish, or shellfish Peanuts are #1 throat Difficulty breathing Hives swelling, rashes Vomiting & diarrhea Decreased BP, loss of consciousness, death © 2007 Thomson - Wadsworth Food Allergies • Food Labeling • Other adverse reactions As of 2006, food labels Monosodium glutamate must indicate the Natural laxatives in prunes presence of the 8 Symptoms of GI problems major food allergens Lactose & other intolerances Equipment must be Psychological reactions scrupulously cleaned to prevent cross• Food dislikes contamination May be nature’s way of protecting against an allergy © 2007 Thomson - Wadsworth Hyperactivity • Affects behavior & learning in 5-10% of young children • No cure • Behavior modification, special education, psych counseling, drug therapy • Not caused by poor nutrition • Lack of sleep, overstimulation, too much TV or video games, too much caffeine, lack of physical activity © 2007 Thomson - Wadsworth Food Choices & Eating Habits of Children • Mealtimes at home • Honoring children’s preferences Should appeal to children’s tastes & provide needed nutrients Should also nurture child’s self-esteem & well-being Sets the stage for lifelong attitudes & habits Favor brown peanut butter, white potatoes, apple wedges, & bread Like raw vegetables Warm not hot food Mild flavors with no lumps © 2007 Thomson - Wadsworth Avoiding Power Struggles • Don’t force to try new foods • Don’t offer rewards to try new foods • Don’t restrict them from eating favorite foods • Offer 1 new food at a time • Small amounts • Need 5-10 exposures to enhance preference • New food at beginning of meal © 2007 Thomson - Wadsworth Mealtimes at Home • Television’s influence • Preventing choking Adversely affects children’s nutritional health Watchers tend to be overweight Snack on advertised fattening foods Child needs to sit when eating Do not let them run with food in the mouth • Play first • Child participation Let them help plan & prepare meals © 2007 Thomson - Wadsworth Meals at Home • Snacks Teach them about healthy snacks Pieces of cheese, sliced strawberries, cooked baby carrots, egg salad on whole-wheat crackers • Preventing dental caries Teach to brush & floss after meals, rinse with water after snacks, avoid sticky snacks, select crisp or fibrous foods • Parents need to serve as role models © 2007 Thomson - Wadsworth Nutrition at School • School Breakfast • School Lunch Most are from lowincome families Provides a minimum of • 1 serving milk • 1 serving fruit or vegetable or full-strength juice • 2 servings of bread or alternate • Two servings of meat or alternate or 1 of each Free or at a reduced price Provides at least 1/3 of recommendations for energy, protein, vitamin A & C, iron, & calcium Must follow Dietary Guidelines for Americans © 2007 Thomson - Wadsworth Competing Influences at School • Why don’t students eat school lunch? Short lunch periods, long waiting lines Competitive meals from fast-food restaurants, a la carte foods or foods from snack bars, school stores, & vending machines © 2007 Thomson - Wadsworth The Teen Years • Physical changes increase nutrient needs • Meeting emotional, intellectual, & social needs is challenging • Make more choices for themselves • Social pressures Alcohol Extreme body ideals Will try latest fad diet to effect immediate changes © 2007 Thomson - Wadsworth Growth & Development • Growth speeds up abruptly & dramatically • Adolescent growth spurt Duration of 2 ½ yrs Males: 12-13 yrs Females: 10-11 yrs • Males Greater muscle & bone 8 inches taller 45 pounds heavier • Females More fat 6 inches taller 35 pounds heavier © 2007 Thomson - Wadsworth Teen Years • Energy & nutrient needs vary depending on rate of growth, gender, body composition, & physical activity • Obesity 15% of U.S. children & adolescents age 619 are overweight • Vitamins Need more vitamin D to increase calcium absorption • Iron Increases for both genders • Calcium Requirements peak Need more milk © 2007 Thomson - Wadsworth Food Choices & Health Habits • Many skip breakfast • Teens have irregular eating • Need to have nutritious, easy to habits grab food in the • Rely on quick refrigerator snacks or fast food Meats for sandwiches • Only 1/3 of teens Low-fat cheeses eat evening meals Fresh raw vegetables & fruits at home Fruit juice & milk © 2007 Thomson - Wadsworth Teen Eating Habits • Snacks • Beverages ¼ of daily energy Most are too high in saturated fat & sodium & low in fiber Also low calcium, iron, & vitamin A Frequently drink soft drinks with lunch, supper, & snacks • Linked to weight gain • Caffeine may become a problem Milk consumption is decreased © 2007 Thomson - Wadsworth Teen Nutrition • Eating away from home 1/3 of all meals are not eaten at home Other meals need to consist of • Peer influence Teens are making their own nutrition decisions Peer influence is great during this time in their lives • Fresh fruits & vegetables • Lean meats & legumes © 2007 Thomson - Wadsworth Problems Adolescents Face • Marijuana Almost ½ of high school students report trying this drug It promotes “the munchies” • Cocaine Craving replaces hunger Weight loss is common • Ecstasy Can damage brain cells, increase heart rate & raise body temperature Lose weight • Drug Abuse in General Produces multiple nutrition problems © 2007 Thomson - Wadsworth Problems Adolescents Face • Alcohol • Smoking By the end of high school • 77% of students have tried it • About ½ have been drunk once Provides energy but no nutrients Every day, 3000 young people start smoking It eases feelings of hunger Smokers have lower intakes of fiber, vitamin A & C, beta-carotene, & folate • Smokeless tobacco Produces bad breath, stained teeth, blunted sense of smell & taste © 2007 Thomson - Wadsworth Nutrition in Practice Childhood Obesity & the Early Development of Chronic Diseases © 2007 Thomson - Wadsworth Childhood Health Problems • Obesity in children is causing an increased prevalence of: Type 2 diabetes Hypertension • Due to overeating, inactivity, & smoking • Leads to cardiovascular disease in adulthood © 2007 Thomson - Wadsworth Some Potential Causes • Genetics • Events during fetal development Does not appear to play a determining role Appears to play a permissive role Theory: malnutrition during a critical period of fetal development may promote a tendency toward obesity later in life Lower birth weight increases risk of adult hypertension © 2007 Thomson - Wadsworth Type 2 Diabetes • Obesity is the most important risk factor • 85% of children diagnoses with type 2 diabetes are obese • Consequences High blood pressure High blood lipids Atherosclerosis Early CVD, kidney disease, blindness, & miscarriages © 2007 Thomson - Wadsworth Children’s Blood Cholesterol • As blood cholesterol increases, atherosclerotic lesions increase • Blood cholesterol rises as saturated fat intake increases • Blood cholesterol correlates with childhood obesity, especially central obesity © 2007 Thomson - Wadsworth Hypertension in Children • Accelerates the development of atherosclerosis • Need regular aerobic activity and weight loss © 2007 Thomson - Wadsworth Epidemic of Obesity • In past 30 years, prevalence in U.S. Has doubled for young children & adolescents Has tripled for children 6-11 yrs • Eating more sugar & more kcalories • Exercising less • Prevention Eat slowly and enjoy companions Stop eating when full Don’t force to clean their plate © 2007 Thomson - Wadsworth Dietary Recommendations • Do not limit fat & cholesterol for infants & children under two • Older children need to replace high-fat foods with Low-fat choices More fruits & vegetables Nuts, vegetable oils, light canned tuna or salmon, low-fat milk © 2007 Thomson - Wadsworth How to Turn the Tide of Obesity • Don’t smoke • Follow the Dietary Guidelines for Americans 2005 • Follow the USDA Food Guide • Be physically active each day • Adults need to be role models for healthy behaviors © 2007 Thomson - Wadsworth