NUTRITION for a Changing World Jamie Pope, Steven Nizielski, and Alison McCook NUTRITION for a Changing World FIRST EDITION Chapter 18 Childhood Nutrition Food Allergies and Intolerances © 2016 by W. H. Freeman and Company & Scientific American

Chapter 18 Objectives Identify four primary objectives for sound nutritional guidance forchildren Provide an overview of patterns of growth and development from preschool-aged children to early adolescence (puberty) Describe how body mass index is used to assess if children are at a healthy weight for their age Identify at least three nutritional challenges for children and adolescents Describe how changes governing the types of foods that are offered at schools are expected to improve the nutrition profile of school meals Describe how parents can use MyPlate to help in planning a healthy diet Describe at least three ways parents can foster positive eating habits and food choices Discuss the consequences of childhood obesity on future health Describe how food allergies develop, and identify four food allergens that are common among children

Could Dirt and Germs Make Children Healthier for Life? The hygiene hypothesis While Russian Karelia and Finland partly share ancestry, inhabitants of Russian Karelia get less microbial infections. This occurs in spite of the fact that the population of Russian Karelia has significantly poorer hygiene standards than affluent Finland. The hygiene hypothesis posits that reduced exposure to childhood infections in developed countries can help explain drastic increases in the rates of allergies and other immune disorders, such as asthma, type 1 diabetes, celiac disease, and multiple sclerosis.

Childhood Growth & Development Growth charts from the Centers for Disease Control and Prevention (CDC)

Childhood Growth & Development Growth charts from the Centers for Disease Control and Prevention (CDC)

What Are Children Eating? Why are children eating so poorly? They eat more meals away from home, particularly at fast-food restaurants. Children between 2 and 18 years of age drink less milk and more sugar-sweetened beverages. These may increase calorie intake and explain the rise in dental carries.

National School Lunch Program Healthy, Hunger-Free Kids Act Federally assisted meal program Passed in 2010 USDA issued new standards to ensure meals line up with the U.S. Dietary Guidelines for Americans Increase fruits and vegetables Emphasize whole grain–rich foods Serve only low-fat and non-fat milk Limit calories Reduce saturated fat and sodium

USDA New School Lunch Standards

Nutritional Recommendations for Children Dietary Reference Intakes (DRI) Acceptable Macronutrient Distribution Ranges (AMDR) U.S. Dietary Guidelines for Americans MyPlate

Nutritional Recommendations for Children

Acceptable Macronutrient Distribution Ranges for Children

MyPlate Food Plan Recommendations

Shaping the Eating Behaviors of Children Eating behavior influenced by physical and social environments Parental influence determines the relationship with food later in life Parents should control Access to foods Timing and location of meals Environment surrounding meals Children as young as 2 years of age should control quantity of food

Shaping the Eating Behaviors of Children Food jags Child’s particular way of eating Normally outgrown with patience and guidance

Shaping the Eating Behaviors of Children Parents can foster positive eating behavior and habits Provide a variety of nutritious foods Repeat exposure to nutritious foods Encourage but do not force nutritious foods Model good eating behaviors

Nutrients of Concern in Childhood Calcium Iron Fiber Vitamin D

Childhood Obesity Obese children at increased risk for High blood pressure High cholesterol Type 2 diabetes Asthma Joint problems Fatty liver disease Psychological problems Obesity as adults

Childhood Obesity

Food Allergies Food allergy Food intolerance Allergen Immune response Lactose intolerance

Food Allergies

Food Allergens There is no cure so avoid foods that elicit allergic reaction Food Allergen Labeling and Consumer Protection Act of 2004 improves labeling information Examples of allergens are Milk Eggs Peanuts Tree nuts Wheat Soy Fish Shellfish

Why Are Allergies Becoming More Common? Heightened awareness The hygiene hypothesis Changes in food manufacturing and processing Mild nutrient deficiencies The timing of when foods are introduced to children

Summary Children grow and develop at varying rates throughout childhood and adolescence Growth standards for children and adolescents 2 to 20 years of age are based on BMI, calculated using height and weight, which are plotted on the Centers for Disease Control and Prevention growth charts, according to a child’s sex and age Puberty represents a dynamic period of development, with periodic growth spurts that result in changes in height, weight, body composition, nutritional requirements, and sex-specific maturation. Growth development during puberty varies widely among all children Nutritional surveys and studies suggest that, overall, U.S. children are consuming more energy-dense, nutrient-poor foods at the expense of nutrient-dense foods

Summary (Cont’d) The National School Lunch Program is a federally assisted meal program operating in public and nonprofit private schools and residential child-care institutions. It provides children with low-cost or free meals that are consistent with the Dietary Guidelines for Americans Children have specific nutrient requirements set through the Dietary Reference Intakes and Acceptable Macronutrient Distribution Ranges, in addition to recommendations from the U.S. Dietary Guidelines for Americans and MyPlate Children of all ages need adequate amounts of all essential nutrients obtained through a varied and balanced diet to support optimal physical and cognitive development

Summary (Cont’d) Parents influence children’s dietary practices in many ways. They establish the eating environment and model health behaviors and attitudes for their children Several nutrients have been identified that are consumed in amounts low enough to be of concern among all or subgroups of children. These include calcium, iron, fiber, and vitamin D Childhood obesity can have a harmful effect on the body in a variety of ways, such as increasing the risk of obesity in adulthood

Summary (Cont’d) National, state, and private programs are actively engaged in efforts to reduce and prevent the prevalence of childhood obesity through education, community-based programs, health-related legislation, food industry changes, and other initiatives that affect the health and weight status of children Food allergies are reproducible, adverse reactions to a food that are caused by a type of immune reaction to an allergen in food, and they can be immediately life-threatening. Common food allergies can involve cow’s milk, eggs, peanuts, tree nuts, wheat, soy, fish, and crustacean shellfish Food intolerances are reproducible, adverse reactions to a food that are not a direct result of an immune response. Food intolerances can produce similar reactions as food allergies, but they are not life threatening and are produced by different mechanisms in the body