Life Cycle Nutrition: Infancy, Childhood,

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Life Cycle NutritionInfancy, Childhood,
Adolescence

• Chapter 16

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Infant Nutrition

• Infants grow faster during 1st year than ever
  again!
• Weight doubles by 4-6 months
• Weight triples by 12 months
• Length increased 50 by 12 months
• Growth is an indicator of nutritional status

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CDC Growth Charts
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Energy Nutrient Needs of the Infant

• Kcalorie needs 100 kcals/kg
• Carbohydrates provide 60 of energy intake (60
  95 grams/d)
• Fat provides most of the energy (30 31 grams/d)
• Protein especially important for growth and
  development (approx. 1.5 grams/kg/day)

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Vitamins Minerals

• More than double the needs of an adult in
  proportion to weight
• Especially high for
• Vitamin A
• Vitamin C
• Vitamin D
• Iodine

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Nutrient Needs of the Infant
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Breast Milk

• Perfect food for infants
• Energy nutrients Protein 6 Carbohydrate
  39 Fat 55.
• Protein Main protein is alpha-lactalbumin
  well-digested absorbed, less stress on immature
  kidneys

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Breast Milk (cont)

• Carbohydrates Disaccharide lactose easily
  digested, enhances Calcium absorption
• Fats Main source of energy EFA linoleic
  linolenic acids, generous amount
• Immunological Protection
• Allergy/Disease Protection

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Figure 16-3Page 547
Percentages of Energy-Yielding Nutrients in
Breast Milk and in Recommended Adult Diets
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Protein
6
55
Fat
28
Carbohydrate
55
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Breast milk
Recommended adult diets
The proportions of energy-yielding nutrients in
human breast milk differ from those recommended
for adults
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Breast Milk

• Vitamins
• Vitamin D content low
• Vitamin D supplementation recommended by AAP for
  breastfed infants
• Vitamin K injection at birth for both breast
  bottle fed infants
• Minerals
• Calcium is well absorbed
• High bioavailability of iron and zinc
• Low in sodium and fluoride

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Recommended Supplements
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Infant Formula

• Composition attempts to copy Breast Milk
  composition
• AAP recommends Iron-fortified formula
• Risks No protective antibodies
• FDA mandates safety nutrition quality of infant
  formulas
• Nursing Bottle Tooth Decay dont sleep with
  bottle

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Introducing Solid Foods

• Birth 4-6 Months
• Breast milk or formula
• Delay cows milk until 12 mo associated with
  intestinal bleeding, iron deficiency
• 4-6 months
• Cereals (begin w/ Fe fortified rice cereal-least
  allergenic) pureed vegs/ fruit

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Feeding tips for infants

• Introduce one food at a time, single-ingredient
  items
• Allow 4-5 days between
• Allergic rxn skin rash, digestive upset,
  respiratory discomfort

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Feeding Progression

• 6 8 months ? Breads/other cereals textured
  vegs/fruits plain, unsweetened fruit juice from
  cup
• 8-10 months? breads/cereals from table yogurt
  soft, cooked vegs finely cut meats, fish,
  casseroles, cheese, egg yolks, legumes

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Feeding Progression, Continued

• 10-12 months
• Most foods (whole milk and egg whites ok)
• 12 months-All foods
• Do NOT give honey until 12 months
• Foods to avoid ? concentrated sweets, canned
  vegetables (high in sodium), honey corn syrup

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Table 16-2Page 552
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Foods at One Year

• 2 -3 cups cows milk
• Use whole milk until age 2, then LF ok
• Excessive milk intake can contribute to anemia
  (milk NOT a good source of Fe)
• Balance and variety from all food groups
• Drink liquids from a cup, not a bottle

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Sample Menu for One Year Old
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In-text Figure Page 544
After six months, energy saved by slower growth
is spent in increased activity.
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Child Nutrition

• Growth and Nutrient needs
• Growth rate decreases at age one year
• Appetite decreases
• Childs appetite fluctuates
• Child regulates own food intake
• Prior to adolescent growth spurt, accumulate
  nutrient stores

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Mypyramid.gov
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Energy and Nutrient Needs

• Needs vary widely because of growth and physical
  activity
• Energy requirements
• 1 year 800 kcals
• 6 years 1,600 kcals
• 10 years 2,000 kcals
• Inactivity can lead to obesity
• Vegans may have difficulty meeting energy needs

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Macronutrient Needs

• Carbohydrate recommendations same as for adults
• Fiber intakes change with age (Age 5)
• Fat
• Ages 1 3 years 30 40 kcals from fat
• Ages 4 18 years 25 35 kcals from fat
• Protein needs increase slightly with age

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Vitamin Mineral Needs

• Needs increase with age
• Balanced diet meets all needs except iron
• Iron-fortified foods are important
• Supplements not needed

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Feeding with Love

• First year of life foundation of emotional and
  physical health set
• Make meal times happy
• Set good example, parents as role models
• Introduce variety of nutritious foods in an
  inviting way

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• Parent
• Responsible for what child is offered to eat
• Child
• Responsible for how much and whether to eat

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Feeding with Love, Continued

• Avoid finish your plate or food as reward
• Allow child to explore and enjoy food
• Dont force food on children
• Discourage unacceptable behavior

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More Tips for Parents

• Children prefer familiar foods-offer foods
  regularly
• Offer vegetables more often
• Serve warm, not hot
• Mild flavors
• Crispy cooked vegetables
• Involve child in meal planning

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More Tips for Parents, Continued

• Offer new foods at beginning of meal )when child
  is hungry, more likely to try)
• Teach children how to snack healthily
• Encourage variety from all food groups
• Limit sweets-children unable to select food based
  on nutrition alone (preference for sweets innate)

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Malnutrition in Children

• Estimated 11 million children in US hungry and in poverty
• Hungry children 2-3 X more likely-- sick
• Chronic hunger? malnourished/growth retardation
• Behavioral symptoms (irritable, aggressive,
  withdrawn) may be d/t malnutrition
• Malnutrition/ lead poisoning linked

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Lead Poisoning
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Hyperactivity

• Also known as Attention Deficit Hyperactivity
  Disorder (ADHD)
• 5 of school-aged children
• ADD not associated w/ poor diet poor diet
  itself-- behavior problems
• Treatment includes behavioral strategies, psych
  counseling, possibly medication

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Food Allergies

• True food allergy vs intolerance
• True food allergy whole food protein/large
  molecule elicits immunological response
• Allergies always involve antibody production
  (without antibody synthesis intolerance)

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Food Allergies

• Food allergy to one food common
• Food allergy to multiple foods exception
• Estimated 3 - 5 children allergic to certain
  foods typically outgrow
• 3 most common food allergies eggs, peanuts,
  milk cause 75 of allergies

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Childhood Obesity

• Dramatic increase in past 20 years
• Est. 1 of 5 children in US overweight
• Factors Genetics, diet, physical inactivity
• Problems Obese children ? obese adults
  Physical health affected with harmful blood
  lipids, high blood pressure, Type 2 DM
  Psychological affects ? poor self-image

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Childhood Obesity

• Prevention/Treatment
• Diet reduce rate of wt gain family meals with
  kcal control eat slowly, stop when full
  nutrient dense foods, portion control never
  force to clean plate
• Physical Activity Recommend at least 30 min
  activity/day parents act as role models
• Psychological support/ Behavioral changes

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Child Nutrition

• Dental Caries A common childhood problem.
  Prevention brush/floss after meals snacks
  Avoid sticky foods Choose crisp/fibrous foods
  for snacks
• Choking Prevention Children should sit when
  eating adult supervision foods most likely to
  cause choking? peanut butter by spoonful,
  popcorn, whole grapes, hot dog pieces, hard
  candies, nuts, raw carrots

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Child Nutrition

• Goal Help form positive eating patterns for
  optimal health throughout life
• Limit empty kcal foods (sodas, sweets, etc)
• Regular mealtimes
• Nutritious snacking
• Limit TV (Est. 30,000 commercials/yr)
• Remember children will imitate adults habits

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School Nutrition

• National School Breakfast and Lunch
• Must include specified servings of milk,
  protein-rich foods, vegetables, fruit, and
  breads/grains
• Designed to provide 1/3 RDI at each meal
• Meal patterns differ based on grade
• Problem what children want vs what theyll eat

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Adolescent Nutrition

• Nutrient needs diverge during adolescence
• Female growth spurt 10 yrs, peak 12 yrs
• Male growth spurt 12, peaks 14 yrs
• Tremendous variation watch individual growth
  pattern
• Also, tremendous variation in energy needs-(can
  increase rapidly overnight!)

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Adolescent Nutrition, Continued

• 25 kcals from snacks
• Keep healthy snack foods in the house
• Kcal needs highest except during pregnancy
• 1/3 of meals are eaten away from home
• Nutrients of concern Iron, Calcium

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Adolescent Nutrition Related Problems

• Smoking
• Decreases appetite
• Eating disorders
• ETOH abuse (ETOH is 1 drug in US) alters
  nutrient absorption metabolism
• Drug abuse

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Early Development of Type 2 Diabetes

• Increased in recent years
• Risk factors
• Obesity
• Sedentary lifestyle
• Family history
• Insulin resistance
• Increased blood cholesterol HTN

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Early Development of Heart Disease

• Hardening of the arteries begins in childhood
• Blood cholesterol tends to rise as saturated fat
  increases
• Correlation with childhood obesity
• Minimize saturated fats and trans fatty acids
• Focus on nutrient dense foods
• Moderation of salt intake