Nutritional Requirement of Children

Young Children

• Encourage young children to eat• sit with children and encourage • feed young children with the rest of the family• do not hurry children• try to feed children as soon as they are hungry• do not feed when children are tired or sleepy• make mealtimes interesting• Check that the child is not sick

Pre School Children

• The best nutrition advise to keep your child healthy includes encouraging her to:

• Eat a variety of foods• Balance the food you eat with physical activity• Choose a diet with plenty of grain products, vegetables

and fruits• Choose a diet low in fat, saturated fat, and cholesterol• Choose a diet moderate in sugars and salt• Choose a diet that provides enough calcium and iron to

meet their growing body's requirements.

To ensure good nutrition in your child and that they grow up healthy, they will need to eat a large variety of food like :

Grain group; 1 slice bread,1/2 cup cereal,1/2 cooked rice –Minimum 6 servings from the grp

Vegetable group:1/2 cup chopped veg ,1 cup leafy veg – 3 servings

Fruit group: I piece of fruit ¾ cup of fruit juice 2 servingsMilk group :1 cup of milk or yoghurt-2 servingsMeat group:2-3 ounces of cooked meat/fish/poultryOR ½ cup

cooked dry beans-2 servings

A NORMAL CHILD B TALL & SLIM CHILD

A & B have same bodyweight.

B should get more food to reach appropriate weight for his height and continue linear growth

Calcium and Iron Reqt

• Preschool age children require about 500 to 800 mg of calcium each day

• Preschool age children require about 10 mg of iron each day.

A NORMAL CHILD

B SHORT FAT CHILD

A & B have same weight. B is short and requires more exercise to get to appropriate weight for his height .

School Going Children

• Nutritional needs at this stage in life• Three balanced meals • One to two snacks during the day• Fat in meals

How are the needs at this stage in life different than the other stages

• School Age Children are still growing• They get to choose what to eat from the

school lunch menu• They are influenced by their friends• They get to purchase snacks during and after

school

• Fats, Oils and SweetsNo more than 30% of your diet should come from fats. For a 1600 calorie diet, that would equal 53g of fat each day and for a 2200 calorie diet, 73g of fat each day

• Milk, Yogurt and Cheese:schoolage child should have 2 to 3 servings of milk, yogurt and cheese each day.

• Meat, Poultry, Fish , Dry Beans, Eggs and NutsFoods in this group provide protein, and vitamins and

minerals, including B vitamins, iron and zinc. 2 to 3 servings of foods from this group each day, including the equivalent of 5 to 7 ounces of lean meat.

Vegetables:Vegetables supply you with vitamins, including vitamin A and C, minerals, such as iron and magnesium, and fiber. Plus they are low in fat. 2 to 4 servings of vegetables each day.

Fruits :Fruits and 100% fruit juices provide Vitamin A and C and potassium. They are also low in fat and sodium. 2-4 servings of fruit each day.

Bread, Cereal, Rice and Pasta: Foods from this group provide complex carbohydrates (starches) , vitamins, minerals, and fiber. 6 to 11 servings of foods from this food group each day.

Calcium: School age children require about 800 mg of calcium each day.

Iron: Require about 10 to 12 mg of iron each day

Nutritional Needs of Adolescents

Big changes: BiologicalBoys—get tall, lean, and dense (bones, that is)

Attain 15% of final adult ht during puberty Lean body mass doublesLarge calorie needs—increase from 2,000 at 10 yr to 3,000 at 15 yr

Stay Tuned for Part 2

• Girls—get taller and fatter– % body fat increases from the teens into the mid-

20s– Gain almost 50% of their adult ideal weight 6-9

mo before ht rate increases during puberty• Dieting can have a negative impact on linear

growth during this time– Calorie needs increase by only 200 from 10 yr to

15 yr

Behaviors with Less Pronounced Consequences

• Eating choices • Physical activity and exercise• Affect adolescents’ sense of well-being,

energy and health in the short term• Affect adult-onset chronic disease risk in the

long term

Another form of Risk-Taking Behavior

Nutrition Issues in Adolescent Health

• Cardiovascular and cancer disease risk• Osteoporosis and bone mineralization• Overweight and obesity• Type 2 diabetes• Eating disorders

• The dramatic physical growth and development experienced by adolescents significantly increases their needs for energy, protein, vitamins and minerals

• Changes in Weight, Body Composition, and Skeletal Mass

• Fiber– Recommended: Age + 5– Consume: ½ this amount

• Fruits and vegetables-– high in fiber and low in fat and sodium– the least consumed food groups for teens– 1/4 eat 2 or more servings of fruit/d– <25% eat at least 5 servings of fruits and

vegetables daily

A variety of factors contribute :GeneticsHormonal changesWeight bearing exerciseSmokingAlcohol consumption

Dietary intake of:CalciumVitamin DProteinPhosphorusBoronIron

• Due to the content of bone (calcium, phosphorus, and protein), adequate intakes of these nutrients are especially important for optimal bone growth and development

Food Ingestion: # 1 on Mom’s ddx

Eating Away from Home

• Teens directly spend more – in fast food restaurants– in food and snack stores– -78%in school

• Fast foods tend to be low in Fe, Ca, riboflavin, vitamin C, and folic acid

• More meals missed at home thus the choice of foods away is more important than the time or place

What Influences Adolescents Food Choices?

• Psychosocial– Strong Influences

• Food preferences– Early childhood experiences, exposure, genetics

• Taste and appearance– Weak influence

• Health and nutrition• Due to the busy lives of adolescents, they

don’t have much time to sit down and eat a meal. Snacking and skipping meals are commonplace among this age group

Reccomendation• Adolescents should be encouraged to make healthier

choices while eating out such as:

• Water, juice or milk instead of Soft drink• Small sandwiches instead of Large choices• Salad or baked potato instead of French fries• Grilled items instead of Fried items• Fruit and yogurt instead of Breakfast• parfait, fruit cup, or sandwiches• pancakes

• Eating together as a family should be encouraged, as adolescents who eat family meals generally have higher intakes of:

Calcium

Fiber Iron

Vitamin A Vitamin C

Vitamin E Vitamin B6

Vitamin B12

Dietary Intake among Adolescents

Protein

The protein needs of adolescents are influenced by the amount of protein required for maintenance of existing lean body mass, plus allowances for

the amount required to accrue additional lean body mass during

puberty.

Intake

CarbohydratesThe recommended daily allowance of

carbohydrates for adolescents is130g/day or 45-65% of daily energy

needs.

Fruits, vegetables, and whole grains should make up the vast majority of

this intake

Dietary Fiber

Dietary fiber is important for normal bowel function and may play a role in the prevention of chronic diseases such as cancers, chronic artery disease, and Type 2 diabetes. Adequate fiber intake is also thought to lower serum cholesterol levels, moderate blood glucose levels, and reduce the risk of obesity.

Dietary Fat

The human body requires fat and fatty acids for normal growth and developmentTwo-thirds of teens meet the recommendations for total fat and saturated fat.

Calcium need and absorption rates are higher during adolescence than any other time except infancy.

Iron

The rapid rate of linear growth, the increase in blood volume, and the onset of menarche all increase the adolescent’s need for iron.

Nutritional Needs of Old age

• Energy requirements• Energy requirements continue to fall with

advancing age.• This is due to the decrease in lean body tissue,

leading to a fall in basic metabolic rate (BMR).• Older people tend to be less active• It is important that the elderly continue to have

a healthy diet and lifestyle such as walking, gardening, dancing in order to maintain a good appetite, maintain mobility and prevent obesity.

• Elderly people have reduced sensitivity to odour and mouthfeel

• Ageing alters saliva flow and composition• This affects ability to breakdown food, inhibits mixing,

retards flavour release and makes swallowing difficult• Older people loose interest in food and food related

activities• The motivation to seek variety in the diet may be

reduced• Leads to consumption of a monotonous diet, reduced

energy intake and deficiency in essential nutrients

• Protein: Is needed for repair of the body cells and therefore foods high in protein are required in the diet. Meat, milk, cereals, bread, nuts, beans etc.

• Fat: Is needed as a source of energy and provides the fat soluble vitamins A,D,E and K. But too much saturated fat can lead to obesity and greater risks of Heart disease

• Carbohydrate: Most of the energy requirements come from carbohydrate foods such as starches and polysaccharides. But there should be a reduction in any form of sweets, buns, biscuits, fizzy drinks to reduce the risk of developing diabetes and HD.

• Fibre helps to prevent constipation which can be common in older people.

• Iron: Eat iron rich foods such as red meat, oily fish, eggs, bread and green vegetables to prevent anaemia. Tannin in tea affects the absorption of Iron into the body

• Vitamin A: Having to much vitamin A might increase the risk of bone fracture.

• Vitamin D: is important for good bone health. It is needed for calcium absorption Older people may not get outside frequently to gain Vitamin D from sunlight. The efficiency of Vitamin D synthesis in the skin may decline with age. It is recommended that anyone over the 65 years takes a supplement of Vitamin D.

• Vitamin B12: the absorption of this vitamin is decreased because the intrinsic factor needed for its absorption is thought to decrease with age.

• Vitamin C: needed to help fight disease needed particularly in old age when the immune system is weak.It also helps to absorb Non haem iron into the body to prevent anaemia. Fruits and Veg

• Folic acid: needed for functions including cell divisions and good nerve function. They are found in green vegetables, brown rice and added to bread and breakfast cereals

• Calcium: Osteoporosis is a major health issue for older people particularly women. This is where the bone density reduces and so the risk of fractures increases. Good sources are: Milk, cheese, yoghurt, canned fish, green leafy vegetables

Factors affecting the nutritional status of older people

• 3 groups of people who suffer from poor health: Elderly on a low income, Elderly living in institutions and those without their own teeth.

• Ill health and medication conditions: Many older people modify their diet to control an illness such as diabetes, heart disease or conditions such as osteoporosis.

• Evidence that oxidative damage may be involved in the formation and progression of cataracts and age related - which can lead to loss of vision. There is a link between these conditions and the lack of antioxidant nutrients

• Poor Dentition: Older people who does not have their natural teeth or had very few teeth ate more restricted foods influenced by their inability to chew. They are less likely to choose foods that are hard to chew such as apples, raw carrots, nuts and oranges.

• Drug – nutrient interaction, alcohol reducing the absorption of nutrients. Drugs affect appetite, saliva production and digestion. Aspirin interferes with the absorption of Vitamin C.

• Mobility and physical movement- People with health problems such as arthritis have difficulty shopping, preparing and cooking food.

• Poverty and economics uncertainty: Older people may not be financially stable to buy a lot of food and they may be on a strict budget due to their benefits or pension.

• Constipation: more common in older people this may be due to the inadequate intake of dietary fibre. Also a reduction in physical activity may contribute to this condition.

• Fluid intake: The sensation of thirst is often diminished in older people. They also limit their intake of fluid to stop them from running to the toilet a lot. Dehydration can occur which can lead to mental confusion, headaches and irritability.

• Drink 6-8 glasses of fluid each day in the form of water, tea, milk, coffee and fruit juice.

Role of supplementation in the diet of older people

• Many older people are not getting adequate nourishment from the foods they eat and are at increased risk of serious health problems requiring hospitalization, Women cover their heads –religious reasons

• They need a vitamin D supplement as they may not get adequate amounts from food and sunlight

Vitamin D and calcium supplements will prevent osteoporosis which will lead to less fractures

and falls by older people.Vitamin C: may need a vitamin C supplement as

they may not be able to chew the fruits and vegetables which provide the vitamin C or they

may not be able to afford the fruit and vegetables. Also vitamin C supplement will help with the absorption of Iron to prevent anaemia

Vitamin B12 supplement: Vitamin B12 is got from animal foods such as meat. The elderly may find it difficult to chew and digest meat.

Folate supplement: can lower the risk of heart disease which is a common disease among older people