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
 Daily dietary reference intakes for
energy 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

 Energy

 Energy needs of healthy children

determined 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
 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 for protein 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 yrs
800 mg/day  4 – 8 yrs
500 mg/day  1 – 3 yrs
 Primary sources : milk & dairy product  children
who consumed no or limited amount  at risk for
poor bone mineralization
 Zinc

 Essential for growth  if deficiency :

- growth failure
- poor appetite
- decreased taste acuity
- poor wound healing
 RDA : 3 mg / day  1 – 3 yrs
5 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 (geographic
location & 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 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
FEEDING PRESCHOOL CHILDREN
(1 – 6 yrs)

 Still gaining height & weight

 Start to walk & talk

Depend on brain development

Depend on genetic & environmental

influences  stimulation & nutrition
 Marked by vast development and the acquisition
of skills
 Decreased interest in food  a difficult time for
parents
 Smaller stomach capacity & variable appetite 
small serving
 Eat 4-6 x/day  snacks is important  should be
chosen carefully
 Should not be given any food or drink within
1½ 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 education
program
 FEEDING SCHOOL-AGE
CHILDREN (6 - 12 yrs)
 May participate in the school lunch program or
bring a lunch from home
 NUTRITIONAL CONCERNS
Obesity

 Increased prevalence
 Not a benign condition
 The longer a child has been overweight  the
more likely the is to be overweight during
adolescent & adulthood
 Factors contributing :
- food establishment
- eating tied to leisure activities
- larger portion size
- inactivity
 Underweight & Failure to Thrive

 Etiology :
- chronic illness
- restricted diet
- poor appetite
- feeding problems
 Iron deficiency
 One of the most common nutrient disorders of
childhood (9% of toddlers)
 Possible factors associated : dietary intake, parent’s
educational level, access to medical care
 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
 Calcium & bone health

 Osteoporosis 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
 Fiber

 Needed for health & normal laxation

 Education is needed to help increase fiber intake
TERIMA KASIH