K - 25 Nutrition in Childhood (Gizi)
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Transcript of K - 25 Nutrition in Childhood (Gizi)
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NUTRITION IN CHILDHOOD
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Nutrient requirementChildren growing & developing
need more nutritious foodMay 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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EnergyEnergy needs of healthy children determined on : - basis of basal metabolism - rate of growth - energy expenditureMust be sufficient to ensure growth & spare protein, but not so excessiveSuggested intake proportions : 50 60% carbohydrate, 25 35% fat, 10 15% protein
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Daily dietary reference intakes for energy for childrenAge Males Females (yr) (kcal) (kcal)
1 21046 9923 81742 16429 132279 2071
IOM, Food and Nutrition Board, 2002
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ProteinEarly childhood 1.1 g /kg BWLate childhood 0.95 g/kg BWAt 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 for protein for childrenAge Grams Grams / kg (yr)
1 313 1.14 819 0.959 1334 0.95
IOM, Food and Nutrition Board, 2002
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Minerals and vitaminsNecessary for normal growth & developmentInsufficient intake impaired growth
deficiency disease
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IronChildren 1 3 years high risk for iron deficiency anemiaRapid growth period Hb & total iron
diet may not be rich in iron-containing food
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CalciumNeeded for adequate mineralization & maintenance of growing bone DRI : 1300 mg/day 9 18 yrs 800 mg/day 4 8 yrs 500 mg/day 1 3 yrsPrimary sources : milk & dairy product children who consumed no or limited amount at risk for poor bone mineralization
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ZincEssential for growth if deficiency : - growth failure - poor appetite - decreased taste acuity - poor wound healingRDA : 3 mg / day 1 3 yrs 5 mg / day 4 8 yrs 8 mg / day 9 13 yrs
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Best sources : meats & seafoodMarginal zinc deficiency reported in children from middle & low-income families (Robert & Heyman, 2000)
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Vitamin DNeeded for calcium absorption & deposition calcium in the bonesThe amount required from dietary sources is depend on nondietary factors (geographic location & time spent outside)Primary sources : vitamin D-fortified milk
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Vitamin-Mineral supplementDo not necessarily fulfill specific nutrient needsChildren who take supplement do not exceed the RDAShould not take megadoses, particularly fat soluble vitamins toxicity
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Children at risk who may benefit from supplementation : - 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 & weightStart to walk & talk
Depend on brain development
Depend on genetic & environmental influences stimulation & nutrition
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Marked by fast development and the acquisition of skillsDecreased interest in food a difficult time for parents Smaller stomach capacity & variable appetite small servingEat 4-6 x/day snacks is important should be chosen carefully
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Should not be given any food or drink within 1 hours of mealExcessive intake of fruit juices chronic non specific diarrheaExcess juice intake may replace the consumption of higher energy foods childs appetite food intake & poor growthChildren usually eat well in group setting ideal environment for nutrition education program
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FEEDING SCHOOL-AGE CHILDREN (6 - 12 yrs)May participate in the school lunch program or bring a lunch from home
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NUTRITIONAL CONCERNSObesityIncreased prevalenceNot a benign conditionThe longer a child has been overweight the more likely the is to be overweight during adolescent & adulthoodFactors contributing : - food establishment - eating tied to leisure activities - larger portion size - inactivity
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Underweight & Failure to ThriveEtiology : - chronic illness - restricted diet - poor appetite - feeding problems
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Iron deficiencyOne of the most common nutrient disorders of childhood (9% of toddlers)Possible factors associated : dietary intake, parents educational level, access to medical care1-yr old child who consume large quantities of milk only milk anemiaDo 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 CariesDrink sweetened liquids from a bottle at bedtime susceptible to early childhood caries (Baby bottle tooth decay)Snacks choose that are least cariogenicChewing sugarless gum salivary pH beneficialToothbrush should be introduced
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AllergiesUsually 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 DisordersAffect the childrens nutrient intake & eating behaviorsTypically eat only specific foods
restricted diet
at risk for inadequate nutrient intakeUsually refuse fruit & vegetablesCommonly very resistant to taking supplement
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Popular dietary intervention : gluten-free and casein-free dietNutrition assessment should include : - the possibility of medication and nutrient interaction - use of alternative therapies, herbal and supplementNutrition intervention may include a behavioral program types of food accepted
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PREVENTING CHRONIC DISEASEDietary fat & cardiovascular healthNCEP 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 healthOsteoporosis prevention : - begins in childhood by maximizing calcium retention & bone density - most efficient during childhood & adolescent Education is needed to encourage young people to consume an appropriate amount
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FiberNeeded for health & normal laxationEducation is needed to help increase fiber intake
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