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8/10/2019 GDS1 K 25 Nutrition in Childhood (Gizi)
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NUTRITION IN
CHILDHOOD
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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
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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
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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
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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
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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
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Minerals and vitamins
Necessary for normal growth & development Insufficient intake impaired growth
deficiency disease
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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
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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
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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
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Best sources : meats & seafood
Marginal zinc deficiency reported in
children from middle & low-income families(Robert & Heyman, 2000)
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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
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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
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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
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FEEDING PRESCHOOL CHILDREN(1 – 6 yrs)
Still gaining height & weight
Start to walk & talk
Depend on brain development
Depend on genetic & environmentalinfluences stimulation & nutrition
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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
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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
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May participate in the school lunch programor bring a lunch from home
FEEDING SCHOOL-AGECHILDREN (6 - 12 yrs)
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Underweight & Failure to Thrive
Etiology :
- chronic illness
- restricted diet- poor appetite
- feeding problems
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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
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Prevention :
- consuming good dietary sources of iron
- the amount of ascorbic acid and MFP to absorption
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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
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Allergies
Usually develop during infancy &childhood and more likely when family
history (+) Allergic responses most often include
respiratory or GI symptom & skin reaction
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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
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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
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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
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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
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Fiber
Needed for health & normal laxation
Education is needed to help increase fiber
intake
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ZZT’07