gds1 k 25 nutrition in childhood (gizi)

8/10/2019 GDS1 K 25 Nutrition in Childhood (Gizi)

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NUTRITION IN

CHILDHOOD



Nutrient requirement

Children growing & developing

need more nutritious food May be at risk for malnutrition if :

- poor appetite for a long period

- eat a limited number of food- dilute their diets significantly with

nutrient poor foods



Energy

Energy needs of healthy childrendetermined on :

- basis of basal metabolism

- rate of growth

- energy expenditure

Must be sufficient to ensure growth & spare

protein, but not so excessive Suggested intake proportions :

50 – 60% carbohydrate, 25 – 35% fat,

10 – 15% protein



Daily dietary reference intakes forenergy for children

Age Males Females

(yr) (kcal) (kcal)

1 – 2 1046 992

3 – 8 1742 1642

9 – 13 2279 2071

IOM, Food and Nutrition Board, 2002



Protein

Early childhood 1.1 g /kg BW

Late childhood 0.95 g/kg BW

At risk for inadequate protein intake :- strict vegan diets

- with multiple food allergies

- who have limited food selection because

of fad diets

- behavioral problems

- inadequate access to food



Daily dietary reference intakes forprotein for children

Age Grams Grams / kg

(yr)

1 – 3 13 1.1

4 – 8 19 0.95

9 – 13 34 0.95

IOM, Food and Nutrition Board, 2002



Minerals and vitamins

Necessary for normal growth & development Insufficient intake impaired growth

deficiency disease



Iron

Children 1 – 3 years high risk for iron

deficiency anemia Rapid growth period Hb & total iron

diet may not be rich in iron-containing food



Calcium

Needed for adequate mineralization &maintenance of growing bone

DRI : 1300 mg/day 9 – 18 yrs800 mg/day 4 – 8 yrs

500 mg/day 1 – 3 yrs

Primary sources : milk & dairy product children who consumed no or limitedamount at risk for poor bonemineralization



Zinc

Essential for growth if deficiency :

- growth failure

- poor appetite- decreased taste acuity

- poor wound healing

RDA : 3 mg / day 1 – 3 yrs5 mg / day 4 – 8 yrs

8 mg / day 9 – 13 yrs



Best sources : meats & seafood

Marginal zinc deficiency reported in

children from middle & low-income families(Robert & Heyman, 2000)



Vitamin D

Needed for calcium absorption & deposition

calcium in the bones The amount required from dietary sources

is depend on nondietary factors (geographiclocation & time spent outside)

Primary sources : vitamin D-fortified milk



Vitamin-Mineral supplement

Do not necessarily fulfill specific nutrient needs

Children who take supplement do not

exceed the RDA Should not take megadoses, particularly fat

soluble vitamins toxicity



Children at risk who may benefit fromsupplementation :

- from deprived families- with anorexia, poor appetites, poor eating habits

- with chronic diseases (cystic fibrosis, liver dis)

- enrolled in dietary programs from weight

management

- vegetarian diets with inadeq intake of dairy product

or calcium containing foods



FEEDING PRESCHOOL CHILDREN(1 – 6 yrs)

Still gaining height & weight

Start to walk & talk

Depend on brain development

Depend on genetic & environmentalinfluences stimulation & nutrition



Marked by fast development and theacquisition of skills

Decreased interest in food a difficult timefor parents

Smaller stomach capacity & variableappetite small serving

Eat 4-6 x/day snacks is important should be chosen carefully



Should not be given any food or drink within1½ hours of meal

Excessive intake of fruit juices chronic non

specific diarrhea Excess juice intake may replace the

consumption of higher energy foods child’s appetite food intake & poor

growth Children usually eat well in group setting

ideal environment for nutrition educationprogram



May participate in the school lunch programor bring a lunch from home

FEEDING SCHOOL-AGECHILDREN (6 - 12 yrs)



Underweight & Failure to Thrive

Etiology :

- chronic illness

- restricted diet- poor appetite

- feeding problems



Iron deficiency

One of the most common nutrient disordersof childhood (9% of toddlers)

Possible factors associated : dietary intake,parent’s educational level, access to medicalcare

1-yr old child who consume large quantities

of milk only

milk anemia Do not like meat iron consumed in the

nonheme form



Prevention :

- consuming good dietary sources of iron

- the amount of ascorbic acid and MFP to absorption



Dental Caries

Drink sweetened liquids from a bottle at bedtime susceptible to early childhood

caries (Baby bottle tooth decay) Snacks choose that are least cariogenic

Chewing sugarless gum salivary pH beneficial

Toothbrush should be introduced



Allergies

Usually develop during infancy &childhood and more likely when family

history (+) Allergic responses most often include

respiratory or GI symptom & skin reaction



Autism Spectrum Disorders

Affect the children’s nutrient intake & eating behaviors

Typically eat only specific foods

restricted diet

at risk for inadequate nutrient intake

Usually refuse fruit & vegetables

Commonly very resistant to taking supplement



Popular dietary intervention : gluten-free andcasein-free diet

Nutrition assessment should include :

- the possibility of medication and nutrientinteraction

- use of alternative therapies, herbal and

supplement

Nutrition intervention may include a behavioral program types of foodaccepted



PREVENTING CHRONIC DISEASE Dietary fat & cardiovascular health

NCEP recommendation (≥ 2 yrs) :

- no more than 30% of calories from fat(≤ 10% SAFA, 10% PUFA, 10-15% MUFA)

- no more than 300 mg/day of cholesterol

> 2 yrs gradually adopt a lower fat diet 4 yrs meet the NCEP guidelines



Calcium & bone health

Osteoporosis prevention :

- begins in childhood by maximizing

calcium retention & bone density- most efficient during childhood &

adolescent

Education is needed to encourage youngpeople to consume an appropriate amount



Fiber

Needed for health & normal laxation

Education is needed to help increase fiber

intake



ZZT’07

gds1 k 25 nutrition in childhood (gizi)

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