Question

1 a.What factors influence the nutrition needs and eating habits of toddlers, preschoolers, and school-aged children?

   b. Consider the factors that influence the changing nutrition needs and eating habits of adolescents. Who is usually at greater nutritional risk during this period, boys or girls? Why? What suggestions do you have for reducing the nutritional risk at this vulnerable age?

Answer 1

                         Nutrients are essential for human health, but also other compounds continue to be identified in foods, and their health properties are becoming better understood. Dietary habits are shaped at a young age and maintained during later life with tracking over time. Eating behaviours established in childhood persist, with implications such as fussiness and poor dietary variety, or high responsiveness to food cues and increased obesity risk.

Factors influencing the nutrition needs and eating habits of toddlers

                    Parents influence children's eating behaviour in a variety of ways: parents actively make food choices for the family, serve as models for dietary choices and patterns, and use feeding practices to reinforce the development of eating patterns and behaviours that they deem appropriate.

1. Smaller capacity, greater need. Toddlers have a smaller stomach capacity than adults, but need a nutrient-rich diet to promote their rapid growth and development1. Many parents are conscious of the importance of nutritious food.

2. Eating behaviour can be affected by the experience of mealtimes as well as the food. If parents gently encourage positive eating behaviours at the table, their toddler should eat enough.

3. Providing self-directed choice. Since every toddler has the ability to regulate their own appetite, parents should create an environment in which a toddler can choose the amount of food they eat. Comparing the amount of food different toddlers eat during this time of rapid development is unhelpful.

FACTORS COMMONLY AFFECTING A TODDLER’S APPETITE

a) EXCESSIVE FLUID INTAKE

                As toddlers have a smaller stomach capacity, offering excessive volumes of fluid or providing fluid at inappropriate times throughout the day will affect their food intake. Toddlers should consume between 1200-1500mls of fluid each day, including milk. Toddlers should consume at least 300mls (10oz) milk, but should not drink more than 600mls (20oz) of milk, in 24 hours. The remaining volume of fluid consumed should be water.

b) UNSTRUCTURED MEALS OR ‘GRAZING’ ON FOOD

                             Toddlers should have a regular routine of three main meals and two or three snacks at similar times each day. This helps to prime a toddler to feel hunger in time for a meal or snack, which should reduce grazing between feeding times. Such a pattern means they are eating roughly every two hours, and so should not be hungry between these times.

c) PRESSURE TO EAT AT MEALTIMES

                    If a toddler feels pressured to eat at mealtimes, they can become anxious close to mealtimes. This nervousness can cause a loss of appetite and reduce food intake. Pressure to eat does not have to be heavy-handed. Even mild pressure or unnecessary prompting to eat can be stressful for some toddlers, and should be avoided.

d) POOR SLEEPING PATTERNS

                 Insufficient sleep can result in an irritable toddler who is less interested in eating or who is less sensitive to their satiety cues. The amount of sleep needed varies by age, but the approximate allocated hours for sleep each day

Factors influencing the nutrition needs and eating habits of preschoolers

1) Family Environment

                          The family can be considered a system, as it is more than the sum of individuals. One relevant aspect of the family environment may be the “family health climate” which is defined as the shared perceptions and cognition concerning a healthy lifestyle within a family. It reflects the individual experience of daily family life, the evaluation of health-related topics, and expectations with respect to typical values, behaviour routines, and interaction patterns within the family.

2) General parental Influences

                              Authoritative parents are demanding and responsive and are characterized by high levels of control and warmth; they monitor the child’s behaviour and convey clear standards without resorting to intrusive or restrictive approaches. Authoritarian parents are demanding and directive with low levels of responsiveness; they exhibit high levels of control [similar to authoritative parents], but in contrast show lower levels of warmth. Permissive parents are less likely to be demanding and to require mature behaviour but exhibit high levels of responsiveness; they tend to be lenient and avoid confrontation. Rejecting/neglecting parents are neither demanding nor responsive.

3) Maternal Influences

                        Mothers are often responsible for determining how much food is offered to their children. However, the factors that influence a mother’s decisions as to how much to offer her children, and her motivations and goals for feeding and consumption are poorly understood. Mothers know the “right amounts” to serve their child and have emotional investments in their children’s eating.

4) Family Meals

                      The physical characteristics of the home environment include the accessibility and availability of different foodstuffs, while family meals represent the key sociocultural setting. Eating the same food as their parents was the best predictor of pre-schooler vegetable consumption.

Factors influencing the nutrition needs and eating habits of school-aged children

                    At age 5 years, children are growing quickly and often become even more active when they start school, They need an adequate intake of energy and a diet that provides all the nutrients needed for growth and development.

              Appetite and capacity for food among 5 year olds are sometimes small, so it is particularly important for such children to have a nutrient-dense diet that includes healthy snacks to ensure nutrient requirements are met.

A. Breakfast

                        Breakfast is important to top up children’s energy stores for the morning’s activities. Children who eat a healthy breakfast are less likely to snack on foods that are high in fat and/or sugar later on and tend to have a better nutrient intake across the day.

B. Healthy weight

                       It is not usually advisable for children of primary school age to go on a slimming diet as this may interfere with their growth and development. Instead, management usually entails a regimen combining healthy eating and increased physical activity, which is family focused and aims to cause the child to remain at a constant weight or increase weight slowly while their height increases and also to review the families dietary patterns and encourage improvement where necessary.

C. School meals and packed lunches

             School meals and packed lunches can make an important contribution to the energy and nutrient intake of children. They tend to be the best option when compared with the quality of food brought from other sources such as cafés and take-aways.

D. Physical activity

                        Physical activity in childhood can be beneficial in terms of social interaction and wellbeing, and it is important for healthy growth and development and maintaining energy balance. By helping a child maintain a healthy weight, physical activity can also reduce the risk of type 2 diabetes or cardiovascular disease. High impact physical activity is particularly important in childhood because it can help to to increase bone mass, which has long-lasting effects on bone health.

Factors that influence the changing nutrition needs and eating habits of adolescents

                Nutritional needs during adolescence are increased because of the increased growth rate and changes in body composition associated with puberty. The dramatic increase in energy and nutrient requirements coincides with other factors that may affect adolescents' food choices, nutrient intake, and thus, nutritional status.

· Biological determinants such as hunger, appetite, and taste

· Economic determinants such as cost, income, availability

· Physical determinants such as access, education, skills (e.g. cooking) and time

· Social determinants such as culture, family, peers and meal patterns

· Psychological determinants such as mood, stress and guilt

· Attitudes, beliefs and knowledge about food

1. Cost and accessibility

              Low-income groups have a greater tendency to consume unbalanced diets and in particular have low intakes of fruit and vegetables. Accessibility to shops is another important physical factor influencing food choice, which is dependent on resources such as transport and geographical location.

1. Education and Knowledge

                 Level of education can influence dietary behaviour during adulthood. Knowledge about health does not lead to direct action when individuals are unsure how to apply their knowledge.

1. Cultural influences

                 Cultural influences lead to the difference in the habitual consumption of certain foods and in traditions of preparation, and in certain cases can lead to restrictions such as exclusion of meat and milk from the diet.

                   

Teen boys are simply physically larger, with more muscle mass than girls, and therefore their calorie intake requirements are greater than 1800-2400 for girls and 2000-3200 for boys.

                    Adolescent girls are particularly vulnerable to malnutrition because they are growing faster than at any time after their first year of life. They need protein, iron, and other micronutrients to support the adolescent growth spurt and meet the body’s increased demand for iron during menstruation. The prevalence of iron deficiency and iron deficiency anemia is higher among adolescent females than males

Under-nutrition negatively affects adolescent girls by:

· Affecting their ability to learn and work at maximum productivity;

· Increasing the risk of poor obstetric outcomes for teen mothers;

· Arresting the healthy development of future children;

· Affecting sexual maturation and growth: and

· Preventing the attainment of normal bone strength and the development of healthy teeth if a youth doesn’t get enough calcium.

Methods to reduce Nutritional risk in Adolescents

          Eating healthy is an important part of a healthy lifestyle and is something that should be taught at a young age.

· Eat 3 meals a day, with healthy snacks.

· Increase fiber in the diet and decrease the use of salt.

· Drink water. Try to avoid drinks that are high in sugar. Fruit juice can have a lot of calories, so limit your teen’s intake. Whole fruit is always a better choice.

· Eat balanced meals.

· When cooking for your teen, try to bake or broil instead of fry.

· Make sure your teen watches (and decreases, if necessary) their sugar intake.

· Eat fruit or vegetables for a snack.

· Decrease the use of butter and heavy gravies.

· Eat more chicken and fish. Limit red meat intake and choose lean cuts when possible.  

• Provide regular daily meal times with social interaction. Demonstrate healthy eating behaviors.
• Involve teens in selecting and preparing foods and teach them to make healthy choices by giving them the chance to select foods based on their nutritional value.
• Select foods with these nutrients when possible: calcium, magnesium, potassium, and fiber.

· To prevent dehydration, encourage teens to drink fluid regularly during physical activity and drink several glasses of water or other fluid after the physical activity is completed.

· Arrange for teens to find out about nutrition for themselves by providing teen-oriented magazines or books with food articles and by encouraging them and supporting their interest in health, cooking, or nutrition.

· Take their suggestions, when possible, regarding foods to prepare at home.

· Experiment with foods outside your own culture.

· Have several nutritious snack foods readily available.