Transcript Normal Nutrition and Development

Normal Nutrition and
Development
Childhood
Estimated cost of child born in 2000
Low $
Middle $
High $
2001
1
6,520
9,070
13,490
2005
5
7,740
10,820
16,000
2010
10
9,480
13,000
18,910
2016
16
13,220
17,910
25,900
Total
18
171,460
223,530
340,130
Expenditure on child 12-14
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Middle income: $ 51,000
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Housing
Food
Transportation
Clothing
Health care
Child care/education
Misc.
2560
1790
1570
790
780
770
1210 Total
9220
Reference Population:
Standard Normal Curve
50th Percentile
5th
95th
Development in childhood
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Differing rates of attainment of milestones
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Toddler
Preschool
School age
Pre-adolescent
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1-3
3-5
6-10
11-13
Basic principles
Children will eat.
Children are capable of regulating food intake.
Children generally react negatively to new
foods but will accept them with time and
experience
Parents can either support or disrupt a child’s
food acceptance and regulation.
Toddlers
A toddler’s job is to:
Explore the world
Establish a sense of self
A parent’s job:
Keep safe
Set limits
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tape
Preschool Children
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Learning about how to get along
Trial and error
Wants to please
Enthusiastic!
Meals
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Has experience
Social
Child feeding programs
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Zinc, folate, vit D and E
WIC:
Food stamps:
Head start:
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Opportunity missed?
CACFP
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Maybe iron?
School age
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Early
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Positive, curious, shows initiative
Prelogical, egocentric
Late
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Independence, achievement
Rules
The beginning of plans
School age
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Low impact everyday activities increases
bone density
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Most active children had 12% more bone in hip
than least active.
High TV watching in girls = less bone density
Boys were more active than girls and had greater
bone density.
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Janz KF, Pediatrics 2001;107:1387-1393
Misc. problems
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Dieting
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Half of girls report weight concerns
Mother’s attitudes matter more to girls
ADHD
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Feingold diet: 5-10% benefit
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Ritalin or Dexadrine: stimulants
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Modified with fruits really ok
Decreased growth secondary to dec appetite
Decreased appetite from ½ hour after taking to 6 hours later
Allergies: associated with dietary deficiency
School breakfast
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Universal Free School Lunch in Inner city
schools
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33% of children were from families where hunger
was common (10%) or likely (23%).
After 4 months: Children who ate breakfast
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Were absent or tardy less often
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There were less trips to the office!
Inc. math scores (2.8 vs 1.9)
Lower perception of hyperactivity by teachers
School breakfast
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Children who ate breakfast
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Were less depressed
Were less anxious
Tended to be healthier
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Murphy JM, Arch Periatric Adolesc Med 1998;152;899907
School Lunch factoids
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If greater than 70% of students are eligible
for free or reduced cost meals, school
breakfast is free for everyone.
If breakfast is delivered to homerooms,
participation increases.
School lunch and breakfast can be modified
to fit a diet Rx, for free.
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May pay for tube feeding formula.
Quality of children’s diets
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Healthy Eating Index: ages 2-9
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Food guide pyramid
Fat % total and saturated
Cholesterol and sodium
Variety
19% good diet
72% needs improvement
9% poor
% Children Meeting Dietary
Recommendations
90
80
70
60
50
40
30
20
10
0
82
46
36
22
grains
37
33
veg
milk
meat
43
Na
variety
29
18
fruit
47
fat
sat fat
chol
% Children Meeting Dietary
Recommendations
100
80
white
60
40
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non-white
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20
0
grains
veg
fruit
milk
meat
fat
sat fat
chol
Na
variety
Differences
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Good diet
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2-3
34%
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Boy
20%
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Low Income 16%
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City
19%
4-6
16%
7-9
Girl
18%
Not low
Suburb
21%
13%
20%
Not
16%
Food sufficient
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Poor diet
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Sufficient
8%
Not sufficient 18%
highest % in survey
Food choices: Texas
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Breakfast: Cereal, juice, whole milk, white bread,
low fat milk, sausage sugar
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Lunch: Fruit, chocolate milk, white bread,
vegetables, ground beef, cheese
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Dinner: Vegetables, ground beef, white bread,
soda, noodles, cheese potatoes
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Snack: fruit, cookies, white bread, chips, soda,
crackers, chocolate
Children’s food choices: NM
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Frequency: Pizza, hamburger, apple, milk, orange,
soda, taco, orange juice, banana, cereal, spaghetti,
egg, chicken, ice cream, corn, chips, Kool-aid, apple
juice, salad, grapes
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Good for you: oranges, apples, bananas, fruits
and vegetables, carrots
 Not good for you: Pizza, hamburger, french fries,
spaghetti, chips, lots of grease, tacos, potatoes, Fry
bread
Fat in diet: 5th grades
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Increased fat:
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Comes from eating out, late night snacks
Living with single mothers
School lunch in “free” schools
Decreased with additional nutrition
knowledge by children!
Iron deficiency
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Anemia, iron deficiency without anemia and
normal iron
NHANES data: 6-16
Math scores
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86.4
87.4
93.7
Carbohydrate and learning
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Epinephrine improves memory
Epinephrine inc blood glucose
In rats peak memory occurs with slightly inc
glucose levels
In humans, overnight fast and then fed or not
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Listen to a story and then tested for memory
100% improvement
Inc. creativity
Sugar
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Sugar load and then crash
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Trend to inc weight correlated with inc intake
soda
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Tiredness
Overweight children drink more soda
Very low fat diets (<20%) may produce inc
lipid levels
Health beliefs in food choice
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For mothers choosing food for children: most
important factor was health
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Taste
Disease prevention
If choosing food for themselves switch taste and
health
For children: taste and health
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Pick health: ate less candy
Pick taste: more fruit and less protein
Fruit and veg. consumption
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Child’s fruit intake:
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Child’s vegetable intake:
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mothers nutrition knowledge,
mother’s consumption,
mother’s belief reduces risk of cancer
Child’s preference
Mother concern for disease prevention
Candy: mother’s intake and child’s health concern
Fruit and veg. consumption
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Child’s fruit intake:
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Child’s vegetable intake:
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mothers nutrition knowledge,
mother’s consumption,
mother’s belief reduces risk of cancer
Child’s preference
Mother concern for disease prevention
Candy: mother’s intake and child’s health concern
Food guidance
Age 2-3
MIlk
½c
Meat
1-2oz
Veg
Age 4-6
4-5 ½-1/3 c
Age 7-12
3-4
½-1c
3-4
1-2 oz
2
2 oz
3-4
2-3 T 4-5
3-4 T
4-5
¼-1/2 c 4-5
Fruit
2-4 T 4-5
4-6 T
4-5
¼-1/2 c 4-5
Bread
½-1
1
3-4
2
3-4
1
4-5
Food Guide Pyramid for kids
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http://www.usda.gov/cnpp/KidsPyra/
Ages 2-6
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Age adjusted portion sizes
Milk and meat 2 servings each
Fruits 2 and vegetables 3
Breads 6