Chapter 12 Child and Preadolescent Nutrition Definitions of the Life Cycle Stage ?? Middle childhood?between the ages of 5 and 10 years ?? Preadolescence?ages 9 to 11 years for girls; ages 10 to 12 years for boys ?? Both may also be termed ?school- age? Importance of Nutrition ?? Establishing healthy eating habits helps prevent immediate & long- term health problems ?? Adequate nutrition associated with improved academic performance Tracking Child and Preadolescent Health ?? Data on U.S. children in 2004 ?? 8% lived in extreme poverty (< 50% of poverty) ?? 40% lived in low-income families (<200% poverty) ?? 11% had no health insurance ?? 33% had no parent in the household who had a full-time, year-round job ?? 31% of families with children were headed by a single parent ?? Disparities in nutrition status exist among different races & ethnic groups Healthy People 2010 Objectives Normal Growth and Development ?? Measurement techniques ?? 2000 CDC growth charts ??Based on data from cycles 2 & 3 of the National Health & Examination Survey (NHES) & the National Health & Nutrition Examination Surveys (NHANES) I, II & III Physiological Development in School-Age Children ?? Muscular strength, motor coordination, & stamina increase ?? In early childhood, body fat reaches a minimum then increases in preparation for adolescent growth spurt ?? Adiposity rebounds between ages 6 to 6.2 years ?? Boys have more lean tissue than girls Cognitive Development in School-Age Children ?? Self-efficacy?the knowledge of what to do and the ability to do it ?? Change from preoperational period to concrete operations ?? Develops sense of self ?? More independent & learn family roles ?? Peer relationships become important Development of Feeding Skills ?? Increased motor coordination & improved feeding skills ?? Masters use of eating utensils ?? Involved in food preparation ?? Complexities of skills increase with age Eating Behaviors ?? Parents & older siblings influence food choices in early childhood with peer influences increasing in preadolescence ?? Parents should be positive role models ?? Family meal-times should be encouraged ?? Media has strong influence on food choices Body Image and Excessive Dieting ?? Young girls are preoccupied with weight & body size at an early age ?? The normal increase in adiposity at this age may be interpreted as the beginning of obesity ?? Imposing controls & restriction of ?forbidden foods? may increase desire & intake of the foods Energy and Nutrient Needs of School-Age Children ?? Energy needs vary by activity level & body size ?? The protein DRI is 0.95 g/kg body wt ?? Intakes of vitamins & minerals appear adequate for most U.S. children DRI for Iron, Zinc and Calcium for School-Age Children Common Nutrition Problems ?? Iron deficiency ??Less common in children than in toddlers ?? Dental caries ??Seen in half of children aged 6 to 8 ??Reduce dental caries by limiting sugary snacks & providing fluoride Prevention of Nutrition- Related Disorders ?? Prevalence of overweight among children is increasing ?? Data from NHANES I, II, & III suggest weight gain linked to inactivity rather than increases in energy intake ?? Excessive body weight increases risk of cardiovascular disease & type 2 diabetes mellitus Prevalence of Overweight and Obesity ?? Definitions: ?? Overweight = BMI-for-age >95 th % ?? At risk for becoming overweight = BMI-for- age from 85 th to 95 th % ?? Based on NHANES 2003-2004 of children ages 6 to 11 years ?? 18.8% are overweight ?? 37.2% are at risk for becoming overweight ?? Overweight more common in Mexican- American males & females and African- American females Characteristics of Overweight Children ?? Compared to normal weight peers, overweight children: ??Are taller ??Have advanced bone ages ??Experience earlier sexual maturity ??Look older ??Are at higher risk for obesity-related chronic diseases Effects of Television Viewing Time ?? Obesity related to hours of television viewing ?? Resting energy expenditure decreases while viewing TV ?? Healthy People 2010 objective: ??Increase proportion of children who view 2 hours or less of TV per day from 60% to 75% Percentage of Children and Adolescents Viewing Television 2 or Fewer Hours Prevention and Treatment of Overweight and Obesity ?? ?An ounce of prevention is worth a pound of cure? ?? Treatment consists of a multicomponent, family-based program consisting of: ?? Parent training ?? Dietary counseling/education ?? Physical activity ?? Behavioral counseling Nutrition and Prevention of CVD in School-Age Children ?? Acceptable range for fat is 25% to 35% of energy for ages 4 to 18 year ?? Limit saturated fats, cholesterol & trans fats ?? Increase soluble fibers, maintain weight, & include ample physical activity Dietary Supplements ?? Supplements not needed for children who eat a varied diet & get ample physical activity ?? If supplements are given, do not exceed the Dietary Reference Intakes Dietary Recommendations ?? Iron ?? Fiber ?? Fat ?? Calcium ?? Fluids ??soft drinks ?? Recommended vs. actual food intake Fluid and Soft Drinks ?? Preadolescents sweat less during exercise than adolescents & adults ?? Provide plain water or sports drinks to prevent dehydration ?? Limit soft drinks because they provide empty calories, displace milk consumption & promote tooth decay Recommended versus Actual Food Intake ?? Saturated fat?intake is 12.6% of calories ?? Total fat?intake excessive in African American boys & girls & Mexican- American girls ?? Caffeine?increasing because of soft drink consumption ?? Fast food?30.3% of children consume fast food each day Nutrient Intake from Snacks Nutrient Intake from Foods Eaten Away from Home Other Considerations ?? Cross-cultural Considerations ??Health care professionals & teachers should learn about cultural dietary practices ?? Vegetarian Diets ??Suggested daily food guides for vegetarians are on the next slides Physical Activity Recommendations ?? Recommendations: ?? Children should engage in at least 60 minutes of physical activity each day ?? Parents should should set a good example, encourage physical activity, and limit media & computer use ?? Actual: ?? Only 17% of middle & junior high schools require daily physical activity ?? Only about 36% of the 5-15 y/o children walk to school & 2% ride a bicycle to school Determinants of Physical Activity ?? Determinants may include: ??Girls are less active than boys ??Physical activity decreases with age ??Season & climate impact level of physical activity ??Physical education classes are decreasing Organized Sports ?? Participation in organized sports linked to lower incidence of overweight ?? AAP recommends: ??Participation in a variety of activities ??Use of proper equipment such as mouth guards, pads, helmets, etc. ??Prevention of stress or overuse injuries ??Awareness of disordered eating & heat injury Nutrition Intervention for Risk Reduction ?It is the position of the American Dietetic Association, the Society of Nutrition Education, and the American School Food Service Association that comprehensive nutrition services must be provided to all of the nation?s preschool through grade twelve students. These nutrition services shall be integrated with a coordinated, comprehensive health program and implemented through a school nutrition policy?.? J Amer Diet Assoc Nutrition Education ?? School-age: a prime time for learning about healthy lifestyles ?? Schools can provide an appropriate environment for nutrition education & learning healthy lifestyles ?? Education may be knowledge-based nutrition education or behavior based on reducing disease risk Guidelines for School Health Programs to Promote Lifelong Healthy Eating Nutrition Integrity in Schools ?? All foods available in schools should be consistent with the U.S. Dietary Guidelines & Dietary Reference Intakes ?? Sound nutrition policies need community & school environment support ?? Community leaders should support the school?s nutrition policy ?? The School Health Index (SHI) should be completed & implemented Eight Components of a Coordinated School Health Program School Health Index Score Card Nutrition Intervention for Risk Reduction ?? Model programs ??5 a Day for Better Health Program ??High 5 Alabama Public Food and Nutrition Programs ?? Child nutrition programs ??Began in 1946 ??Provide nutritious meals to all children ??Reinforce nutrition education ??Require schools to develop a wellness policy Public Food and Nutrition Programs ?? The National School Lunch Program Menu Planning Approaches: 1. traditional food-based menu planning 2. enhanced food-based menu planning 3. nutrient standard menu planning 4. assisted nutrient menu planning Traditional Food-based menu-planning approach menu pattern for lunches School Breakfast Program ?? Authorized in 1966 ?? States may require schools who serve needy populations to provide school breakfast ?? Breakfast must provide ¼ the DRI Other School Nutrition Programs ?? Summer Food Service Program ??Provides summer meals to areas with >50% of students from low-income families ?? Team Nutrition ??Provides training, technical assistance, education or support to promote nutrition in schools Antonio/Jen Vega/Hess 3612 - Chapter12.ppt
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