Preschoolers/schoolers

• Nutrition in children of all ages is instrumental for healthy

development in all areas of living physical, psychological and
social wellbeing. A diet inadequate in nutrient dense foods may
result in delayed development, psychomotor delay and
behavioral disorders. These are all preventable by educating
parents and families about basic nutrition.

• Nutrition can be defined as what foods the individual consumes

and how the body uses them.
 Young children should not be regarded as young adults.
 As they are still growing, in order to achieve satisfactory growth children
require larger amounts of nutrients per unit of body weight than adults.
 Therefore, when children are fed foods which contain inadequate amounts
of nutrients, they may fail to grow and develop adequately.
 1 Lack of adequate nutrition will cause failure to gain weight in the short
term and in the longer term will result in small stature.
 Energy Energy requirements for preschool children increase as the child
grows older:
 A one year old girl requires 1,165 kcal/day
 A one year boy needs 1,230 kcal/day
 A four year old girl requires 1,545 kcal/day
 A four year a boy needs 1,715 kcal/day.

 Fats
 A low fat diet for children can result in insufficient energy.
 Fat is a concentrated source of energy, fat soluble vitamins and essential
fatty acids.
 Fats also make food more palatable
 A diet with adequate amounts of fat enables children to take in energy in
a limited volume of food as they have small stomachs and cannot eat
large volumes.
 It is necessary to educate parents particularly that low fat milks and
foods are not suitable for young children.

 Fibre
 Fibre foods are bulky and young children with small appetites who are
offered a diet high in fibre, may not ingest adequate energy.
 Phytate, a substance associated with cereal fibre, can bind with and
prevent the efficient absorption of certain minerals such as calcium,
phosphorus, iron, copper and zinc.
 1 Children who may be eating sufficient amounts of these minerals but are
consuming too much fibre, may actually become deficient in these
minerals.
 Dietary fibre should be encouraged but not excessively so in small
children.
 Wholemeal bread, wholemeal breakfast cereals, pulse vegetables, fruit
and vegetables all should be encouraged, particularly as the child gets
older.
 Protein
 Protein intake ranges from 14.5g/day in 13 year olds up to 19.7g/day in
46 year olds.
 All preschool children should have adequate intake of protein and they
can eat meat, dairy produce, eggs, chicken and fish to meet their protein
needs.

 Iron
 Iron intakes in children have been shown to be low 3 and many preschool
children have been found to be anemic.
 A study carried out in a general practice setting in 1995 found that 36% of
one year olds were anemic
 Following the introduction of education programmed for mothers by primary
care professionals, one year later it was found that the percentage of anemic
children had decreased to 24% of 122 children screened at 14 months.
 The practice nurse can educate parents with regard to increasing iron in the diet
through iron rich foods such as red meat, liver, fortified cereals and green
vegetables.
 Vitamin C increases the absorption of iron from food and a small drink of juice
should be offered at mealtimes.
 Carbohydrates
 Carbohydrates are an important source of energy.
 Starchy foods such as pasta, bread and rice should be plentiful in the diet.
Payne in 1991 found that the main source of sugar in the diet of preschool
children was pure fruit juices and blackcurrant syrups.
 There are strong links between sugar intake and the incidence of dental
caries, particularly in preschool children.
 To minimize the risks, parents should be encouraged to discontinue the
use of feeding bottles after the age of one and to encourage the use of
feeding cups.
 Also, frequent consumption of sugary drinks, sweets and snacks should be
discouraged as these influence the child's appetite.
 Fluid
 Fluid intake is a matter of concern in preschool children.
 A study carried out in 1995 demonstrated that squash was the most
popular drink, with milk coming in second.
 Plain water was much lower in popularity.
 The authors suggest that children as young as two become conditioned to
the sweet taste of squash so that they refuse to drink water.
 Children with a high intake of squash may have a diminished appetite and
as a result miss out on valuable nutrients at meal times.
 Again, a high intake of squash will affect children's dentition.
 Problems with nutrition in preschool children
 Phases of eating patterns are common in the preschool years.
 There may be an obvious cause such as illness or the arrival of a sibling, but
phases or fads usually reflect the child's developing independence and the
need to assert individuality.
 Family attitudes can affect the child's eating habits and behavior.
 Food and eating is a learning experience for children and also can be a
source of frustration and the cause of many arguments between parents.
 However, healthy children will not starve themselves and usually what isn't
consumed at one meal will be made up for at the next.
 Excessive milk intake (greater than 1.5 pints per day) can diminish the
appetite and as a result the child may not eat properly at mealtimes.
 It is important that parents encourage dental health early on in life with
regular visits to the dentist started at an early age.
 Sweets are better consumed after a meal rather than between meals.
 Teeth should be cleaned twice daily after breakfast and before bedtime.
 Parents require education antenatal and education should be continued
and reinforced when parents attend for immunization and developmental
checks.
 Childhood obesity

 Childhood obesity has become an epidemic. Overweight has doubled n

the last 20 – 30 years and 1 on 5 children are now overweight.
 Obese children may also have increase blood pressure, heart rate,
cardiac output, type 2 diabetes, sleep apnea and hyperlipidemia.
 We can help them by turning off TV and computer and encourage them
to do the walking exercises for at least 60 min a day. Encourage them to
engage in several activities.
 Type 2 diabetes

 Most obese children develop type 2 diabetes at the age of 10 – 14

 Should see the certified diabetes educator to learn what to eat to control
their diabetes.
 Educator should also prescribed daily exercise and attention to fiber
intake