1. Chapter 15 NUTRITION FROM INFANCY TO ADOLESCENCE

2. 15.1 Starting Right for a Healthy Life
Learning objectives
Discuss the quality of the diet of Canadian children and youth.
Describe the trends in obesity and chronic disease among adolescents.
Explain how children develop their eating habits. 2

3. What are Canadian Children Eating?
CCHS found diets of Canadian children and youth are not as healthy as they could be.
Canadian Healthy Eating Index show younger children have higher average scores that decline with age.
About 25% of adolescents score less than 50/100 points.
Low scores are due to an inadequate number of servings of fruits and vegetables, milk and alternatives, and grain products. 3

4. What are Canadian Children Eating?
Saturated fat and sodium intake are higher than desirable. 20% of children and 30% of adolescents consume kcalories in excess of their needs.
20% of children and 40% of adolescents consume food purchased at fast food outlets.
The Canadian Health Measures Surveys (CMHS) found fitness levels have declined since 1981.
The proportion of obese/overweight children and youth has doubled since 1978.
Childhood obesity increases risk for chronic disease. 4

5. What are Canadian Children Eating?
Figure 15.2 (a)

6. What are Canadian Children Eating?
Figure 15.2 (b)

7. Diet-Related Disease Conditions in Children
High-kcalorie, high-saturated fat diets combined with low-activity lifestyles can lead to the following:
Obesity
Type 2 diabetes
Elevated serum cholesterol
Heart disease
Hypertension 7

8. 15.2 Nourishing Infants, Toddlers, and Young Children
Learning objectives
Describe the best indicator of adequate nutrient intake in children.
Compare the energy, macronutrient, and micronutrient needs of infant and children with those of adults.
Describe the recommendations for feeding infants.
Describe strategies that ensure the children receive a balanced, nutritious diet. 8

9. Monitoring Children’s Growth
Figure Body mass index-for-age-percentiles for boys 2 to 19 years.
Source: Based on the World Health Organization (WHO) Child Growth Standards (2006) and WHO Reference (2007) adapted for Canada by
Dietitians of Canada, Canadian Paediatric Society, the College of Family Physicians of Canada and Community Health Nurses of Canada.
© Dietitians of Canada. All rights reserved. Permission to print in its entirety. For noncommercial use only.
Figure 15.5 9

10. Monitoring Children’s Growth
Figure Body mass index-for-age-percentiles for boys 2 to 19 years.
Source: Based on the World Health Organization (WHO) Child Growth Standards (2006) and WHO Reference (2007) adapted for Canada by
Dietitians of Canada, Canadian Paediatric Society, the College of Family Physicians of Canada and Community Health Nurses of Canada.
© Dietitians of Canada. All rights reserved. Permission to print in its entirety. For noncommercial use only.
Figure 15.5 10

11. Figure 15.6 Total energy and protein needs by age and gender.
The total need for both energy and protein increases with age. 11

12. Figure 15.6 Total energy and protein needs by age and gender.
The total need for both energy and protein increases with age. 12

13. Energy and Protein Needs for Children
Figure 15.6 Total energy and protein needs by age and gender.
The total need for both energy and protein increases with age.
Figure 15.6 13

14. Reading Labels of Foods for Young Children
Food labels on products designed for young children (under age 2) must follow different rules.
Nutrient Facts Table
fat must be listed as total fat
Percentage Daily Value must be omitted for total fat, saturated fat, cholesterol, total carbohydrate, fibre, and sodium
Percentage Daily Value must be listed for vitamins and minerals

15. Reading Labels of Foods for Young Children
Nutrient claims permitted on product label:
claims for protein, sodium, and sugar content
claims describing percentage of vitamins or minerals that apply to the Daily Values permitted
Nutrient claims not permitted on product label:
claims about a food’s nutrient content or health effects

16. Typical Meals for Infants and Young Children16

17. Food Allergies and Food Intolerances
Food allergies are more common in infants than in adults.
Exposure to an allergen for the first time causes the immune system to produce antibodies to that allergen.
Allergy symptoms include sneezing, rash, eczema, hives, cramps, aches, vomiting, asthma, diarrhea 17

18. Food Allergies and Food Intolerances
Allergy symptoms may be immediate or take up to 24 hours to appear.
Allergy symptoms may range from mild to life-threatening.
Food intolerances do not cause antibody production, they create problems during digestion.
Example: Lactose intolerance, an inability to digest milk sugar 18

19. Food Allergies and Product Labels
Labels must indicate whether the product contains any of the top 8 food allergens:
milk
eggs
fish
shellfish
peanuts
tree nuts
wheat
soy

20. Food Allergies and Product Labels
Allergens most often listed at the end of the ingredient list after the word “Contains.”
Where there is possibility of cross contamination, the label will contain a statement to warn consumers beginning with “may contain” or “not suitable for.”

21. Canada’s Food Guide Figure 15.9
Figure 15.9 Canada’s Food Guide Recommendations for children
Canada’s Food Guide recommends amounts from each food group based on age.
Source: Health Canada. Eating Well with Canada’s Food Guide 21

22. Meal Patterns for Children of Different Ages
Table 15.2 22

23. Healthy Snacks for Young Children23

24. 15.3 Nutrition and Health Concerns in Children
Learning objectives
Describe how certain foods contribute to dental caries.
Describe whether there is a link between hyperactivity and diet.
Describe the consequences of lead toxicity.
Describe the factors that influence childhood obesity. 24

25. Nutrition and Health Concerns in Children
A number of diet and lifestyle factors put children at risk for illness and malnutrition. They can include:
Dental caries
Lead toxicity
Hyperactivity
Childhood obesity 25

26. What Can Be Done to Reduce Lead Exposure
Source: Health Canada. Lead information package. Available online at Accessed July 1, 2014. 26

27. Lead Toxicity
Figure 15.9 Canada’s Food Guide Recommendations for children
Canada’s Food Guide recommends amounts from each food group based on age.
Source: Health Canada. Eating Well with Canada’s Food Guide
Figure 15.14 27

28. Figure 15.9 Canada’s Food Guide Recommendations for children
Canada’s Food Guide recommends amounts from each food group based on age.
Source: Health Canada. Eating Well with Canada’s Food Guide 28

29. Preventing Childhood Obesity29

30. Types of Foods Advertised Saturday Morning
Figure Types of foods advertised on children’s Saturday morning television
A high percentage of foods advertised on children’s television is high in fat, sugar, or salt and low in nutrient density.
Source: Batada, A, Seitz, M, Wotan, M, et al. Nine out of Ten Food Advertisements Shown During Saturday Morning Children’s Television Programming are for Food High in Fat. Sodium or Added Sugars, or Low in Nutrients J. Am. Diet. Assoc. 108:673–678, 2008.
Figure 15.16 30

31. Canadian Children’s Food and Beverage Advertising Initiative
The principles promoted by this initiative include:
advertise only healthy dietary choices to children under 12
include only healthy foods in interactive games directed to children under 12
no food and beverage product placement in children’s programming
no advertising in elementary schools

32. Fitness for Children 32

33. Fitness For Children Figure 15.18
Figure Canada’s Physical Activity Guidelines for children (a) and youth (b).
Source: Canadian Physical Activity Guidelines, © Used with permission from the Canadian Society for Exercise Physiology,
guidelines.

34. 15.4 Adolescents Learning objectives
Describe how growth and body composition are affected by puberty.
Describe how energy, macronutrient, and micronutrient needs of adolescents are related to growth and sexual maturation.
Describe changes that can be made in a typical teen’s diet that would improve diet quality. 34

35. The adolescent growth spurt
Figure 15.19 35

36. Lean Body Mass in Adolescent Males Versus Females
Figure Body composition of males and females
After puberty, males have a higher percentage of lean body mass and less body fat than females.
Source: Adapted from Forbes, G. B. Body composition. In Present Knowledge in Nutrition, 6th ed. M. L. Brown, ed. Washington, DC: International Life Sciences Institute-Nutrition Foundation, 1990.
Figure 15.20 36

37. Dietary Concerns for Teenagers
CCHS findings:
Boys and girls aged 9 to 18 did not have adequate intake of Vitamin A
Girls 14 to 18 had low intake of B6, folate, and B12
12% of adolescent girls were not meeting their iron requirements
70% of girls aged 9 to 13 years and 30% of boys aged 14 to 18 years were not meeting their requirements for calcium
15% of girls aged 9 to 13 and 20% of girls aged 14 to 18 were not meeting their zinc requirements
Low intake of vitamin A – not meeting recommended servings CFG for vegetables and fruit
Low iron intake girls need more iron, tend to eat fewer iron-rich foods and consume fewer overall kcalories.
Low calcium intake is due to increased consumption of soft drinks 37

38. Dietary Concerns for Teenagers
Teenagers’ inadequate vitamin A intake comes from not consuming the recommended number of servings for fruits and vegetables.
Girls’ inadequate iron intake is because their needs are high. Girls tend to eat fewer iron-rich foods and consume fewer overall kcalories.
Teenagers’ inadequate calcium intake is due to their increased consumption of soft drinks. 38

39. Dietary Concerns for Teenagers
Figure Average consumption of milk and soft drinks (ml) among Canadian children and teens.
Consumption of milk declines while that of soft drinks increases with age.
Source: Garriguet, D. Beverage consumption of children and teens. Health Reports 19(4):1-6, Available online at Accessed December 26, 2010.
Figure 15.21

40. Dietary Concerns for Adolescents
Adolescence is a time of independence and changed behaviours.
Dietary choices in adolescence can lead to nutrient deficiencies. 40

41. Dietary Concerns for Adolescents
Adolescents may be making decisions about:
Vegetarianism
Eating for appearance and/or performance
Smoking
Alcohol use
Oral contraceptive use
Teenage pregnancy

42. Meeting Adolescents’ Nutrient Needs
Figure Canada’s Food Guide recommendations for teens
Canada’s Food Guide recommends amounts from each food group based on age and sex.
Source: with permission from Health Canada. Eating Well with Canada’s Food Guide,. Available online at pdf. Accessed Sept 10, 2011.
Figure 15.22

43. Copyright
Copyright © 2015 John Wiley & Sons Canada, Ltd. All rights reserved. Reproduction or translation of this work beyond that permitted by Access Copyright (The Canadian Copyright Licensing Agency) is unlawful. Requests for further information should be addressed to the Permissions Department, John Wiley & Sons Canada, Ltd. The purchaser may make back-up copies for his or her own use only and not for distribution or resale. The author and the publisher assume no responsibility for errors, omissions, or damages caused by the use of these programs or from the use of the information contained herein. . 43