1. 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

2. 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

3. 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.

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

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

6. 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.

7. 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

8. USDA New School Lunch Standards

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

10. Nutritional Recommendations for Children

11. Acceptable Macronutrient Distribution Ranges for Children

12. MyPlate Food Plan Recommendations

13. 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

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

15. 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

16. Nutrients of Concern in Childhood
Calcium
Iron
Fiber
Vitamin D

17. 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

18. Childhood Obesity

19. Food Allergies Food allergy Food intolerance Allergen Immune response
Lactose intolerance

20. Food Allergies

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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