Nutrition for children and adolescents
Children and adolescents
Pre-school children (1-5 years of age)
The nutrition of children between being weaned and starting school is important. Food habits are established in this phase of life. They are less under parental control than they used to be.
Young children have different taste perception from adults. They prefer sweeter foods, dislike bitter tastes, and often object to vegetables of the cabbage family.
Young children’s eating is still mostly controlled by their mothers. There are Four simple principles which can help.
- (1) Eat from each of the four basic groups every day (the fifth will accompany the basic four). These four basic food groups contain all the essential nutrients between them.
- (2) Aim for variety within each food group—for example not always the same vegetable. The modern child should be prepared to eat food from other cultures. Food neophobia is a social handicap in later life. Young children should be able to eat most of the same food as the rest of the family.
- (3) To minimise dental caries, sweets and other sugary foods should be rationed and not eaten between meals as a rule.
- (4) The most likely nutrient deficiency is a low iron status with mild anaemia. The easiest way to prevent this is for the child to be given meat, chicken or fish regularly, which provide haem iron.
After having a reliable appetite for their first twelve months, some children aged 1-3 go through a phase of poor eating, which can make parents anxious or even exasperated. Children are less enthusiastic about eating and refuse foods that the rest of the family eat,
One reason for this is that growth slows at around twelve months. This can be seen in the changes in gradient of normal weight for age, and height for age curves. It is even more obvious in weight and height velocity curves, which descend to about a quarter and a half, respectively, of the values in early infancy. Energy intake can be very variable from time to time in toddlers.
Other things are also happening. Children are discovering their independence and testing their choice in food selection. Once they have some control over what is offered, foods that they find unattractive are displaced by those they think delicious: cakes, biscuits, chocolate, crisps, ice cream, etc.
Children are growing taller than ever. Deficiency is limited to a few micronutrients and usually subclinical. Iron nutrition is low in a minority of older girls (their requirements increased by menstruation) and plasma 25-OH vitamin D is low in some susceptible children.
The main nutritional concerns in school children are
- the increasing percentage who are overweight, even obese
- Vegetable, fruit and whole grain consumptions are often below dietary guideline recommendations.
- the continuing opportunity to minimise dental caries by reducing the time that teeth are exposed to acid-producing carbohydrates in the mouth
- diets of socially deprived children can be of poorer quality.
It has been agreed that overweight can be diagnosed with body mass index (kg/m2) using
reference curves worked out for children’s different ages.
The role of high fat foods in the epidemic of overweight is generally known, and realised among school children themselves, though cheese or biscuits may not be recognised as high fat.
Energy expenditure has fallen in young people. Many do not participate in sport, are driven to school and spend hours everyday looking at television or a personal computer. Children who watch more TV have higher BMIs and most of the food adverts they see are for fast foods, high in fat, sugar or salt.
eenagers are not fed, they eat. During this time they are intensely involved in day-to-day life with their peers, and preparation for their future lives as adults.
Few become interested in foods and nutrition except as part of a cult or fad such as vegetarianism or crash dieting. Several facets of eating behaviour are different or more pronounced in adolescents than in other people and each may cause concern in the older generation.
, especially breakfast.
Eating snacks and confectionery. The major snack is usually in the afternoon, after school. Snacks tend to be high in empty calories — fat, sugar, and alcohol—but some provide calcium (for example milk) or vitamin C (fruit).
Fast, take-away, or carry-out foods
. These provide some nutritious portions, but adolescents may not choose balanced meals from what is offered. There is not enough accessible information about the nutrient composition of fast foods.
may be eaten in combinations and permutations that other members of the family do not approve of, but they often add up to an adequate nutritional mix.
Start of alcohol consumption
. This is the most dangerous of the new food habits. Alcohol-related accidents are the leading cause of death in the 15-24 year age group.
Soft drinks and other fun drinks
. If they are an alternative to alcoholic drinks soft drinks should not be discouraged, but (unless sweetened with aspartame, etc) they provide only empty calories and by replacing milk can reduce the intake of calcium. Bottled pure water is a healthy trend.
High energy intakes
. Many adolescents go through a phase of eating much more than adults, sometimes up to 16.7 MJ per day (4000 kcal). This seems to occur near the age of peak height velocity in girls (around 12 years), but in boys may come later than the age of peak height velocity (usually 14 years). Presumably the larger, more muscular male adolescent is expending more energy at this stage.
Low levels of some nutrients
. Iron deficiency is quite common in adolescent girls who are menstruating, still growing, and often restricting their food intake. It may sometimes occur in boys too. Calcium accretion in the skeleton can be as much as 100 g/year at peak height velocity.
. There are two aspects to this: overweight/obesity and social dieting. Obese adolescents are usually inactive and tend to have low socio-economic status. Increased exercise should be emphasised and anorectic drugs should not be used.
Does diet affect acne?
The popular belief is that chocolate, fatty foods, soft drinks, and beer can all aggravate acne vulgaris. This is not surprising since 85% of people have acne at some time during adolescence and most adolescents eat and enjoy these foods.
No young person wants to lose their teeth and spoil their good looks. As in children, sticky sugary foods should not be eaten between meals, or if they are, the teeth should be thoroughly brushed afterwards.