Backgrounder On Child & Adolescent Nutrition Nutritionists and other health professionals have long recognized the importance of establishing healthful nutrition practices during childhood. Indeed, the diet and exercise patterns adopted during these prime development years set the stage for lifetime habits that can spell the difference between health and infirmity in later years. Infant Nutrition From birth to two years, a period characterized by rapid growth, gains in weight and height are the primary indices of nutritional status. Breast-feeding is encouraged for at least the first four-to-six months of life for nutritional as well as immunological benefits to the infant. Among the most common nutritional disorders during infancy is iron deficiency anemia, which is routinely screened through blood tests of hemoglobin or hematocrit. "Solid" foods are usually introduced about four-to-six months of age, particularly iron-fortified cereals to help prevent this problem. Other foods such as strained fruits and vegetables and fruit juice are gradually introduced, until by about 12 months of age when most babies are eating small, tender table foods. In children under two years of age, dietary fat plays a key role in the formation vital nerve and brain tissues. Health professionals do not recommend feeding fat-reduced foods to children of this age. For example, use of whole milk rather than low-fat or skim milk is advised. Infants should never be put to bed with a bottle of milk, formula, or other liquid to help guard against developing nursing bottle caries. Growing Up Nutrition recommendations for teens and children over the age of two differ little from those for adults, (see Chapter 5, Backgrounder on Adult Nutrition). A wide variety of food, rich in essential nutrients necessary for growing bodies, forms the basis of recommendations. As indicated in the Food Guide Pyramid, such foods include carbohydrate-rich grain foods and fruits and vegetables necessary to supply vitamins, minerals, fiber and energy vital to good health. Adequate amounts of dairy products, lean meats, fish, poultry, eggs, dry beans and nuts also provide nutrients that contribute to proper growth and development. Most children will grow about two inches per year and gain about four to seven pounds per year. Between the ages of six to 12, youngsters will grow an average of one to two feet and almost double in weight. Diminished weight-for-height may be indicative of acute undernutrition; a decreased height for age may suggest chronic undernutrition. Such growth failure may be due to malnutrition, psychosocial deprivation, eating disorders, underlying chronic disease, infection or other factors. While children often have definite food likes and dislikes, nutritionists recommend parents make available a wide variety of foods and encourage tasting new foods in small quantities without forcing the issue. In this manner, children will often come to accept and like new foods. As with adults, dietary guidelines also encourage children age two and over to limit their consumption of dietary fat to 30 percent of calories. Obesity and overweight is a significant problem for a growing number of American youngsters. Although a small percentage of obese children may attribute their problem to endocrine disorder or other underlying physical problems. Studies show that the level of caloric intake among children has remained constant in recent years, but that levels of physical activity have markedly decreased. Some 20 to 40 percent of American youngsters are physically unfit. Most health experts do not recommend that overweight children be put on a diet per se, but rather emphasize increased exercise as a life-long approach to weight management and good health. Teen Nutrition Adolescents need extra nutrients to support the adolescent growth spurt, which begins in girls at ages 10 or 11, reaches its peak at age 12 and is completed at about 15. In boys, it begins at 12 or 13 years of age, peaks at 14 and ends at about 19. In addition to other nutrients, adequate amounts of iron and calcium are particularly important as the body undergoes this intensive growth period. From ages 11 to 24 years, both males and females are encouraged to consume a calcium-rich diet (1200 milligrams daily) in order to help ensure adequate calcium deposition in the bones during the age at which peak bone mass is attained. This may help reduce the incidence of osteoporosis in later years. By eating at least three servings daily from the Milk, Yogurt & Cheese group, the recommended calcium intake easily can be achieved. Teens' caloric needs vary depending on their growth rate, degree of physical maturation or body composition and activity level. Overweight is one of the most serious nutrition problems of adolescents, particularly among Native Americans, Hispanics and low-income African-Americans. Eating disorders also are common among teens, whose food choices are often influenced by social pressure to achieve cultural ideals of thinness, gain peer acceptance, or assert independence from parental authority. According to the National Center for Health Statistics, one in 100 females between the ages of 12 and 18 has anorexia nervosa that causes people to severely limit their food intake. Both anorexia and bulimia, in which people binge and purge by vomiting or using laxatives, can lead to convulsions, kidney failure, irregular heartbeats, osteoporosis and dental erosion. Meal Patterns To meet energy needs throughout the day, children and teens should eat at least three meals a day, beginning with breakfast. Studies show eating breakfast affects both cognitive and physical performance; that is, if a child eats breakfast, he or she may be more alert in school and better able to learn and perform sports or other physical activities. Snacks also form an integral part of meal patterns for children and teens. Young children generally cannot eat large quantities at one sitting and get hungry long before the next regular mealtime. Mid-morning and mid-afternoon snacks are generally advised for this age. Fast-growing, active teens may have tremendous energy needs. Even though their regular meals can be substantial, they still may need snacks to supply energy between meals and to meet their daily nutrient needs. Reprinted from the International Food Information Council Foundation, 1995

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