Nutritional Needs of Preschool and School Going Children

NUTRITIONAL NEEDS OF PRESCHOOL AND SCHOOL GOING CHILDREN

The rapid growth during infancy is followed by a generally slow growth between one to six years. The child becomes more active and the social and environmental influences have a great impact on their food behaviour and eat-ing pattern. The need for nutrients is increased as growth and development continues.

Growth Pattern

During the second year, the increase in height is about 10 cm and weight gain is 2 to 2.5 kg. After two years annual gain in height and weight is only 6 to 7 cm and 1.5 to 2 kg respectively. However, there is a wide variance in the physical develop-ment of children.

As growth proceeds, changes occur in a) proportion of water, b) muscle tis-sue, c) fat deposits and d) skeletal struc-ture. The body water gradually decreases and there is addition of adipose tissue and minerals to the bones.

Nutritional Needs During Preschool

Energy

The energy needs for the child is deter-mined by his basal metabolism and activ-ity. If the preschool child is not given proper complementary foods and supple-mentary foods, it may lead to protein and energy malnutrition.

Protein

Protein is a vital dietary component for pre-schoolers, as it is needed for optimal growth. Enough protein should be con-sumed every day for proper growth and development.

Fat

Adequate fat is required to provide the extra calories and reduce bulk in the diet.

Minerals

Calcium is needed for bone and teeth min-eralization and maintenance. The amount of calcium a child needs is determined in part by the consumption of other nutri-ents, such as protein, phosphorus and vitamin D, as well as the child’s rate of growth.

Iron requirement during childhood is needed for growth and for increase in the haemoglobin concentration. Dietary lack of iron accompanied by hookworm infestation can lead to anaemia. Zinc is essential for proper development. It is needed for wound healing, proper sense of taste, proper growth, and normal appetite.

30%–50% of aneamia in children and other age groups is caused by iron deficiency (World Health Organization 2007).

Vitamins

The incidence of Vitamin A deficiency is high. The recommended intake for B vita-mins is based on the energy intake. The dietary intake of vitamin C for pre-school-ers is the same as for adults i.e., 40 mg/day

Dietary Guidelines

Transition from an infant diet to a regular adult diet should be smooth and gradual. Factors that need to be considered while planning a diet for a preschool child are:

·        The food should be interesting and attractive. For example, chapattis, poori and bread slices can be cut into interesting shapes to make eating interesting for a child.

·        The diet should include enough quan-tity and quality of different nutrients. They should be encouraged to have milk every day. Milk can be given with delicious flavours.

·        Plenty of fruits and vegetables are needed for proper elimination.

·        Fruits are given raw or in the form of simple desserts.

·        Unripe bananas and apples should not be given as they are difficult to chew and may choke the child.

·        Candies and sweets should be in mod-eration. Foods like tea and coffee should not be given as they are more stimulating to the system.

·        Foods should be seasoned so that they taste better and the child takes it well.

·        Fried foods and concentrated foods should not be given as they are diffi-cult to digest.

·        The Child should never be forced to eat more than what he can take and the atmosphere should be peaceful, pleas-ant and lacking distraction.

·        People feeding the child should not show dislike of any food in front of the child; this may lead to the rejection of the food by the child.

·        Regularity of meals is essential.

·        Food preferences of the child should be taken into consideration.

Nutritional Problems among Pre-Schoolers

Protein-Energy Malnutrition (PEM)

The primary cause of malnutrition is a faulty and inadequate diet. Besides diet and socioeconomic factors, various envi-ronmental factors aggravate the dietary deficiencies. These include chronic infec-tion, poor environmental sanitation, poor insanitary living conditions and poor per-sonal hygiene. The diseases that represent extreme forms of PEM are

·        Kwashiorkor

·        Marasmus, and

·        Marasmic Kwashiorkor

Vitamin-A deficiency

Inadequate dietary intake of vitamin A or its precursor (E-carotene) is exhibited as Bitot’s spots, kertomalacia in preschool children.

The school-age, six to twelve years, has been called the latent time of growth. The rate of growth slows down and body changes occur gradually. The slow rate of growth dur-ing this period result in a gradual decline in food requirement per unit of body weight.

Energy

Energy needs vary with growth rate, body size and physical activity. The require-ment for calories increases during school age.

Protein

Girls require more protein than boys because they are reaching menarche. The protein requirements are slightly higher for girls than boys between 10-12 years.

Minerals

Calcium requirements are more to meet the need for skeletal development. They need to take 2-3 glasses of milk. Iron requirement is further increased by rise in the haemoglobin concentration.

Vitamins

Vitamin-A requirements of children is 600μg. Vitamin-C requirements are 40mg. Vitamin B complex requirements increase with calorie needs. The RDA of vitamins A and C are same as adult RDA.

Food Requirements

A natural increase in appetite is respon-sible for an increase in food consump-tion. Parents should encourage the child to eat appropriate portion sizes, eating a variety of food to meet their nutritional requirements.

Importance of breakfast

·        Children who skip breakfast do not make up for the nutrition and energy needs and tend to perform poorly in academics(NIN, 2003-2004)

·        Eating breakfast is a healthy habit.

·        An ideal breakfast should have all 4 basic food groups.

Dietary Guidelines for School Children

·        Nutritional requirements should meet their activity, growth and spe-cial requirements during sickness and injury.

·        Menus should provide dishes that are quick to eat, nutritious and variety is needed.

·        Weather conditions should also be considered-in hot season more of liq-uid should be included.

·        Snacky meals should be given at inter-vals which can be easy to handle.

·        Fruits and dry fruits can be given for snacks.