Spotlight F: Childhood nutrition

The hygiene hypothesis

• Reduced exposure to childhood infections in developed countries can help explain drastic increases in rates of allergies and other immune disorders, such as asthma

Growth chart

• age appropriate growth rates of adequate nutrition

• CDC growth charts serve as reference to comparison

  Weight or height at or under 5th percentile for his/her age is at risk for undernutrition

  85th or 95th percentile of BMI-for-age are at risk of being overweight and obese, respectively

  

Growth in early childhood

Growth slows in preschool children aged 2-5 years after the rapid growth during infancy

Average increases

• Weight ↑ 4.5-6.6 pounds per year
• Height ↑ 3-4 inches per year

Growth in School-aged Children

Children vary in height, weight, and build during the school years due to genetics, nutrition, and exercise patterns

Age 6-11

• Growth spurts
• Periods of accelerated physical development
• Weight ↑ 6.5 pounds/year on average
• Height ↑ 2+ inches/year on average

Growth during Puberty

~50% of adult body weight is gained during puberty

Boys

• Typically begins at age 12 or 13
• Average gain of ~2.5 inches in height and 11+ pounds in weight a year for a span of about 4 years

Girls

• Typically begins at age 10 or 11
• Average gain of ~2 inches in height and ~9 pounds in fat and lean mass a year

Diets of children in the U. S. are typically
↑energy-density
↓nutrient-density
↓fiber
↓vegetables
↓greens and beans
↓whole grains
↓plant proteins

added sugars account for approximately 40% of total calorie intake in 2- to 18-year-olds

children eat poorly because they More meals away from home and

Drink less milk and more soft drinks

National school lunch program

Federally assisted program that provides nutritionally balanced, low-cost or free meals to children each school day

2010 Healthy, Hunger-Free Kids Act
USDA issued new standards in 2012 to ensure meals align with Dietary Guidelines for Americans

AMDRs for Children

healthful ranges of macronutrient intake for growth and development

Children as young as 2 should control the quantity of food consumed to avoid excess intake and habitual overeating

Physical activity

U.S. Department of Health and Human Services (HHS) recommend children and adolescents older than 6 years engage in:
60 minutes or more of physical activity per day

Health benefits

Lower risk excessive weight gain, Improved bone health and weight status Improved cognitive function, Improved quality of sleep, Reduced symptoms depression and anxiety, Lower activity associated with lower diet quality

nutrients concern

Calcium
Important for bone health and optimizing bone mass
Iron
Supports growth and prevents iron-deficiency anemia
Replaces iron lost through menstruation in adolescent girls
Fiber
Alleviates constipation
Shown to reduce the risk of chronic diseases
Vitamin D
Crucial for skeletal health and optimal bone development
Healthcare providers may recommend supplementation as intake recommendation recently increased by 50%

Childhood Obesity and Disease

Approximately 17% of American children and adolescents aged 2–19 are currently obese Obese children are at increased risk for multiple physical and psychological problems:

(High blood pressure, High cholesterol, Type 2 diabetes, Asthma Joint problems, Fatty liver disease, Psychological problems, Bullying and negative stereotyping, Obesity as adults)

Overweight and obese children are at an increased risk of becoming obese as adults

Energy-dense foods, larger portion sizes, more meals away from home

preventing obesity

National, state, and private programs are working to reduce and prevent the prevalence of childhood obesity

Food allergy is a reproducible, adverse reaction to a food caused an immune response to an allergen in that food
The number of people with food allergies is growing without a clear reason why

process: sensation allergic reaction symptom

CDC lists eight foods that cause 90% of allergic reactions
For those allergic to one or more foods, consuming even minute amounts can be immediately life-threatening

Reproducible adverse reaction to a food that is not a direct result of an antibody (IgE)-dependent immune response
Can induce allergy-like gastrointestinal and respiratory symptoms
Not life-threatening and result from different bodily mechanisms

ex: lactose intolerance & celiac disease

No “cure” for allergies
Avoid allergen
Food Allergen Labeling and Consumer Protection Act of 2004
Manufacturers must declare the presence of major food allergens on food packages

Avoiding common allergens such as fish, eggs, and peanuts during pregnancy, breastfeeding, or beyond 4‒6 months of age does not seem to be protective

2017 new guidelines issued advising early introduction of foods containing peanuts to infants to reduce risk of peanut allergy

LEAP study showed that introducing peanut-containing foods to infants at high risk of the allergy was safe and led to an 81% reduction in subsequent peanut allergy