During early childhood and school-age years, children begin to establish habits for eating and exercise that stick with them for their entire lives. If children establish healthy habits, their risk for developing many chronic diseases will be greatly decreased. On the other hand, poor eating habits and physical inactivity during childhood set the stage for health problems in adulthood.
Unfortunately, many children living in the United States have unhealthy eating and exercise habits, as evidenced by the growing number of overweight children. Since the late 1980s, the number of overweight children in the United States has more than doubled, so that currently approximately 11% of American children are overweight and an additional 14% have a body mass index (a ratio of weight to height) between the 85th and 95th percentiles, which puts them at increased risk for becoming overweight.
In addition, a survey conducted by the Centers for Disease Control and Prevention showed that 48% of girls and 26% of boys do not engage in vigorous exercise on a regular basis. Overweight children are more likely to become obese adults, and are, therefore, at increased risk for developing cardiovascular disease, hypertension, diabetes, gallbladder disease, osteoarthritis, and some cancers in adulthood.
Childhood obesity also has emotional consequences, as many overweight children suffer from psychological stress, poor body image, and low self-esteem. Parents can help children establish healthy eating habits by making nutritious foods available, by limiting the consumption of junk foods, by turning off the television during mealtime, by allowing children to participate in food preparation, and by controlling the amount of food they eat.
Care should be taken to ensure sufficient intake of calcium, vitamin D, fiber, and calories. Dietary fat and cholesterol should be limited to no more than 30% of total calories and 300 mg per day, respectively.
In contrast to the rapid physical growth and development experienced during infancy and adolescence, the childhood years, loosely defined as the years between 2 and 11, are typically characterized by much slower and more stable physical growth.
On average, children gain 4 to 7 pounds and gain 1 to 4 inches per year. At approximately age 10 or 11 the rate of growth once again begins to increase, an indication that the child will soon enter puberty.
As a result of this slower physical growth and development, the body's needs for certain nutrients, most notably calories and protein, is not as high as during infancy. Interestingly, the body naturally compensates for this, and, as a result, it is not at all uncommon to see a young child with a decreased or inconsistent appetite.
On the other hand, as children enter school and begin to participate in organized sports and other activities that result in an increase in physical activity, their appetite and food intake usually increases.
Starting school and participating in other structured activities places new social, emotional, and mental demands on children. Consequently, the school-age years are characterized by intense development in social and cognitive skills.
Without adequate nutrition, children will experience physical and mental fatigue, have difficulty concentrating on learning tasks, and will ultimately exhibit slower cognitive and behavioral development.
It is important for school-age children to meet the recommended intake levels of all essential vitamins and minerals. The Dietary Reference Intakes for this age group are shown in the table below. The nutrients highlighted below are of special importance:
Caloric needs vary depending on the child's current rate of growth, the amount of physical activity, and the child's metabolism. It is important that children consume enough calories to ensure proper growth and to spare protein from being used for energy. However, many children, especially those who are not physically active, tend to consume too many calories. Children aged 2 to 3 years, 4 to 6 years, and 7 to 10 years require approximately 1300, 1800, and 2000 calories, respectively.
The amount of protein needed per kilogram of body weight decreases after infancy and early childhood, from 1.2 gram/kg at 3 years to 1 gram/kg at 10 years. On average, children in the United States consume considerably more protein than is required for health. Protein deficiency is relatively rare in children living in the United States, but may be seen in children with severe food allergies, in those on strict vegan diets, or in those who have limited access to food.
Many children consume too much dietary fat, which can lead to excessive calorie consumption and weight gain. As a result, nutrition experts believe that by the age of 5, children should follow adult recommendations for the consumption of fat. These recommendations suggest that total fat intake not exceed 30% of calories and saturated fat should account for no more than 10% of total calories. In addition, cholesterol intake should not exceed 300 mg per day.
With the growing recognition of the importance of dietary fiber to health, children, like adults, are encouraged to increase their dietary fiber intake. Children should consume their age plus 5 grams of fiber per day.
In 1997, the National Academy of Sciences increased the recommended intake amount of calcium, a mineral necessary for proper bone growth and maintenance of bone density, for school age children from 500 mg per day to 1300 mg per day. This change was made in recognition of the fact that childhood is an important time for increasing bone density, and increasing bone density during childhood can help prevent osteoporosis later in life.
Although many foods contain calcium, milk is the primary source of calcium in the diets of children in the United States. So, children who do not drink milk, must take care to include a variety of food sources of calcium in their diet. In addition, adequate intake of vitamin D is necessary for proper calcium absorption and to ensure calcium deposition in bone tissue.
|Nutrient||1-3 years||4-8 years||M 9-13||F 9-13|
|Vitamin A (mcg RE||300||400||600||600|
|Vitamin D (mcg)||5||5||5||5|
|Vitamin E (mg alpha-TE)||6||7||11||11|
|Vitamin K (mcg)||30||55||60||60|
|Thiamin (mg)||500 mcg||600 mcg||900 mcg||900 mcg|
|Riboflavin (mg)||500 mcg||600 mcg||900 mcg||900 mcg|
|Niacin (mg NE)||6||8||12||12|
|Pantothenic Acid (mg)||2||3||4||4|
|Vitamin B6 (mg)||500 mcg||600 mcg||1||1|
|Vitamin B12 (mcg)||900 pcg||1.2||1.8||1.8|
|Vitamin C (mg)||15||25||45||45|
The eating habits and attitudes about food displayed by parents have tremendous influence on the food choices of children. In fact, the food likes and dislikes that become firmly established during childhood are, to a large extent, shaped by the food likes and dislikes of parents.
It is important for parents who are concerned that their children eat too few vegetables or too many junk foods to take a look at their own eating habits and reevaluate the example they are setting for their kids.
As any parent knows, instilling healthy eating habits in children is challenging and requires patience. Here are a few suggestions to help turn a picky eater into a healthy eater:
It is an understatement to say that television influences the food choices of children. On average, today's children spend more time watching television than they spend at school, or doing any other activity besides sleeping. Consequently, children are bombarded with commercials, many of which advertise food.
The foods most frequently advertised during programs for children are sweetened breakfast cereals, fast foods, candy, soda pop, and snack foods. It is well-known by nutrition experts and parents alike that most children are very responsive to these commercials and that, in response to media messages, children will try to influence their parents food buying decisions.
As a result, a connection can often be made between a family's hours of television viewing and the number of snack foods purchased. And, for many kids, watching television leads to weight gain and ultimately obesity, caused by excessive snacking and lack of physical activity.
Unfortunately, television negatively impacts the health and nutrition status of children in other, less obvious ways. In television programs and commercials, food is used for many activities besides the satisfaction of hunger.
Also, very few overweight people are used in television programs, and, in fact, many actors could be considered underweight. As a result, children are repeatedly given the message that what we eat, how much we eat, or when we eat has no impact on our weight, health or nutrition status.
During the schoolage years, children begin to spend more time away from home, either at school or at the homes of their friends. Consequently, factors outside of the home start to influence food choices, which can have either a negative or positive impact on nutrition.
In many cases, peers reinforce poor food choices and contribute to negative body image. In fact, research suggests that the preoccupation with weight and body shape that is typically characteristic of the adolescent years may actually begin in elementary school.
On the other hand, school age children are capable of understanding the role of nutrition in health. As a result, nutrition education messages provided at school can help children understand the importance of good nutrition.