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Nutrition
INTRODUCTION
• Balanced and sufficient nutritional intake is
most essential for children to promote optimal
growth and development, to protect and
maintain health, to prevent nutritional
deficiency conditions and various illnesses and
to reserve for starvation and dietary stress.
The word nutrition is derived from the word
'nutricus' which means to suckle at the breast.
DEFINITION
• Nutrition is defined as combination of
dynamic process by which the consumed food
is utilized for nourishment and structural and
functional efficiency of every cell of the body.
It is the science of food and its relationship to
health.
• The term 'food' refers to anything which
nourishes the body. It includes solids,
semisolids and liquids which can be consumed
and which help to sustain the body and keep it
healthy.
• Food and nutrition are different and having
different meaning, Food is defined as what
one feeds on and is a composite mixture of
many nutrient substances ranging from a
fraction of a gram in some cases to hundred of
grams in others. Food stuff is defined as
anything which can be used for food
NUTRITIONAL REQUIREMENTS IN
CHILDREN
Nutritional requirements may vary from one
individual others and depends upon metabolic
and genetic difference No single food meets
all the essential requirements for children
except mother's milk, which provides all
nutritional substances to the infant till 6
months of age.
• After wards healthy dietary habits depend
upon cultural and influence and contribute to
personal and social enjoyment So, to fulfil the
nutritional requirements, child's diet should
be planned by the parents and family
members with different types of food items to
provide balanced and nutritious diet.
• The child's diet should contain sufficient
amount of fluids calories, protein fats,
carbohydrates, vitamins, minerals and salts to
meet their daily nutritional needs. Food items
should be digestible, palatable, attractive,
choiceable and easily available.
• Nutritional requirements should be
maintained with margin of safety and with
right balance. A deficit or excess in nutrients
could be harmful and should be avoided. The
'recommended daily intake' of nutrients with
sufficient amounts to be provided to maintain
needs of the body and good health,
Water
Water is most important for maintenance of life. It
constitutes about 70% of body weight in children.
The total water content of the body is
comparatively higher in infants than in adults.
Water is required for digestion, metabolism, renal
excretion temperature regulation, transportation
of cellular substances, maintenance of fluid
volume and growth of children.
• The daily requirement of water is fulfilled by
fluid intake, food and oxidation processes in
the body. Water is absorbed throughout the
intestinal tract. The balance of water depends
on the protein & electrolyte intake, solute
load, metabolic and respiratory rates and
body temperature. Evaporation from the lungs
& skin accounts for 40 to 50 % water loss & 3
to 10% by fecal loss.
• The water and electrolyte balance by varying
amount and concentration of urine. Excess
loss of water can cause dehydration whereas
an excess intake can result in water
intoxication. Loss of water or dehydration is an
important cause of death in children even
than starvation. Water intoxication may found
as edema, circulatory failure, abdominal
distress or convulsions.
• Calories
The energy value of foods is measured in terms of
'large' calorie or kilocalorie. The production of
energy varies during the oxidation of different
foods. Children required more calories per kg of
body weight than adults. Calorie requirements
gradually decrease from infancy to adulthood.
The average energy expenditure is 50% in basal
metabolism 12% in growth, 25% for physical
activity, 8% in fecal loss and 5% for specific
dynamic action.
• The calorie requirements of children depend
upon body size and surface area, rate of
growth, level of physical activity, food habits
and climate. In a balanced diet, 50% of
calories is provided by carbohydrates, 15% by
proteins and 35% by fat. Deficiency of calorie
intake leads to loss of weight, growth failure
and protein-energy malnutrition. An excess
intake of calorie results in increased weight
gain and obesity.
• Proteins
Proteins are essential for synthesis of body
tissues in growth, and during maintenance
and repair. They help in the formation of
digestive juices, hormones, plasma proteins,
enzymes, hemoglobin and immunoglobulins.
They are needed for maintenance of osmotic
pressure and acid base equilibrium.
• Proteins also act as source of energy, when
the calorie intake is inadequate. Excess
proteins, which are not used for building
tissues or providing energy, converted by the
liver into fat and stored in body tissues.
• Proteins are made up of simpler substances
called amino acids. There are 24 amino acids
to be needed by the human body, of which '9'
are called essential amino acids, because the
body cannot synthesize them in amounts of
their need and therefore must be supplied in
the diet.
• Both essential and nonessential amino acids
are required for synthesis of tissue proteins.
Proteins are obtained from two main dietary
sources, i.e. animal origin and vegetable
origin. Proteins of animal sources are
biologically complete protein with all essential
amino acids and more easily digestible.
• Proteins of vegetable sources are incomplete
and lack of one or more amino acids. The
combination of vegetable proteins may
provide all the essential amino acids. This is
the reason that vegetarian diet should have
mixing of 3 to 4 types of pulses or
combination of wheat and legumes.
• Protein requirements depend upon the age,
sex, physical and physiological factors. It is
found maximum in neonates and early infancy
but gradually decreases as age increases. Extra
amount of protein should be provided during
illness to compensate the destruction or
degeneration of body tissue, e.g. in blood loss,
surgery, etc.
• Deficiency of protein intake in food results in
growth failure and protein-energy
malnutrition.
• Carbohydrates
Carbohydrates are main source of energy and
supply bulk in the diet. They contribute taste
and texture of foods. They are digestion and
absorption of other foods. carbohydrate
intake in diet allows the use of protein for
tissue synthesis, otherwise protein is also used
for energy production and fat is metabolized
with production of ketone bodies.
• Excess carbohydrates are stored in the liver
and muscle. Carbohydrates play an important
part in infant nutrition as they spare proteins
to be fully utilized for growth and various
repair processes. Carbohydrates are
consumed as monosaccharides (glucose,
fructose, galactose), disaccharides (lactose,
sucrose, maltose, isomaltose) and
polysaccharides (starch, dextrin, glycogen,
gum, fibers, cellulose).
• All carbohydrates are ultimately oxidized and
converts to glucose. Glucose is used as fuel by
brain and muscle or converted to glycogen
and stored in liver and muscle. Excess
carbohydrates are converted to fat. The source
of carbohydrate of infant's diet is in the form
of lactose found in both human and cow's
milk that should be provided up to 6 months.
• Afterwards cereals, legumes, fruits, tubers,
pulses and vegetables are the main sources.
Lack of adequate carbohydrate intake may
produce symptoms of starvation, under
nutrition, constipation, fatigue, loss of body
protein, ketosis, depression and carbohydrate
malnutrition. Excess carbohydrate to obesity,
,ischemic heart disease etc .
• Fat
Fat supplies 40 to 50% energy needed for
infant. It provides protection and support for
organs and insulation of the body as adipose
tissue. It acts as carriers of fat-soluble vitamins
and components of cells and tissue. Fats and
oils are concentrated sources of energy and
make the foods palatable. Fats and oils are
termed as lipids.
• Lipids are classified as simple, compound and
derived. Simple lipids are monoglycerides,
diglycerides and triglycerides, which are
combination of glycerol and fatty acids.
Compound lipids are combination of simple
lipids with nonlipid substance such as
glycolipids, phospholipids and lipoproteins.
• Fats are available from both animal and vegetable
sources. About 98% of neutral fats are
triglycerides and other 2% include free fatty
acids, monoglycerides, diglycerides, cholesterol
and phospholipids. Fatty acids are divided into
saturated and unsaturated fatty acids, which are
further divided in monounsaturated and
polyunsaturated fatty acids. Polyunsaturated fatty
acids are mostly available in vegetable oils and
the saturated fatty acids available in the animal
oils.
• Exceptionally, fish oils contain poly and
monounsaturated fatty acids whereas coconut
and palm oils have extremely high percentage
of saturated fatty acids. Essential fatty acids
are those that cannot be synthesized in the
human body and should be derived only from
food. The most essential fatty acid is linoleic
acid, which is abundantly available in
vegetable oils.
• It helps in maintenance of good health.
Saturated fat should not be more than 10% of
total fat intake. More fat intake in diet may
results in indigestion as it remains longer in
the stomach.
• Excess fat intake leads to excess accumulation
of adipose tissue, obesity, NIDDM, cancer,
atherosclerosis and hypertension. Deficiency
of all essential fatty acids may result in growth
retardation and skin disorders, susceptibility
to infections, neurological and visual problems
and decreased myocardial contractility. The
ICMR has recommended a daily fat intake of
25 g/ day in young children and 22g / day in
older children.
• Vitamins
Vitamins are organic substances and essential
micronutrients for maintenance of normal health. They
are available in many foods in small amounts. .
Balanced diet supplies all the vitamins needed for a
healthy individual. Vitamins act as cofactor in many
enzyme systems and essential for energy production,
hemopoiesis, reproduction, neurological functions,
hydroxylation and synthesis of fats, amino acids,
nucleic acids and nucleoprotein. They enable the body
to use other nutrients and help in maintenance and
protection of good health.
• Vitamins are classified into two groups, i.e.
fat-soluble and water-soluble vitamins. Fat-
soluble vitamins are linA, D E and K. They are
stored in body fat and needed only in minimal
amount in daily diet. Excess intake of these
may produce toxic effects. The water-soluble
vitamins are vitamin B and C. They are not
stored in the body and required in adequate
amount in daily diet to prevent deficiency
conditions.
• Water soluble vitamins are easily destroyed
during food processing, preparation and
storage. Each vitamin has a specific function to
perform and deficiency of any particular
vitamin may result in specific deficiency
• Many factors are responsible for the vitamin
deficiency conditions. They include poor
dietary intake, faulty absorption, increased
loss in chronic diarrhea, greater demand
during fever, infections and metabolic diseases
and poor utilization in chronic liver diseases.
• Vitamin requirements are more in preterm
babies. Infants get adequate vitamins from
mother during lactation. Dietary intake of
vitamins may be low or marginal during
infancy and childhood. The minimum intake
for the maintenance of health in respect of
many of the vitamins has been determined.
• Minerals
Minerals are inorganic elements, required by
human body for growth, repair and
regulations of vital body functions. They act as
catalysts in biochemical reactions. More than
50 minerals are found in the human body, all
of which must be derived from foods. A well-
balanced diet supplies sufficient quantities of
minerals.
• Minerals are required for maintenance of
osmotic pressure, supply of necessary
electrolytes for the actions of muscles and
nerves and for hemopoiesis. Minerals are
classified as macrominerals when the daily
requirement is 100 mg or more and as
microminerals when less than 100 mg is
required daily.
• Macrominerals are calcium, phosphorus,
sodium, potassium and magnesium.
Microminerals or trace elements required by
the body in quantities of less than few mg per
day and include iron, iodine, fluorine, zinc,
copper, cobalt etc
• Minerals deficiencies are less among
vegetarians than nonvegetarians. Adequate
amount of protein in daily diet prevents
minerals deficiencies.
Conclusion
• The health and nutritional status of an infant and
subsequent growth and development through
childhood depend upon successful feeding
practices. The socioeconomic status and
education of the mother and family members
have been known to influence child's feeding
behavior. Nutritional counseling is the important
responsibility of the nurse to promote the
nutritional status of the children and to prevent
nutritional deficiency diseases.

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nutrition preventive pediatric.pptx

  • 2. INTRODUCTION • Balanced and sufficient nutritional intake is most essential for children to promote optimal growth and development, to protect and maintain health, to prevent nutritional deficiency conditions and various illnesses and to reserve for starvation and dietary stress. The word nutrition is derived from the word 'nutricus' which means to suckle at the breast.
  • 3. DEFINITION • Nutrition is defined as combination of dynamic process by which the consumed food is utilized for nourishment and structural and functional efficiency of every cell of the body. It is the science of food and its relationship to health.
  • 4. • The term 'food' refers to anything which nourishes the body. It includes solids, semisolids and liquids which can be consumed and which help to sustain the body and keep it healthy.
  • 5. • Food and nutrition are different and having different meaning, Food is defined as what one feeds on and is a composite mixture of many nutrient substances ranging from a fraction of a gram in some cases to hundred of grams in others. Food stuff is defined as anything which can be used for food
  • 6. NUTRITIONAL REQUIREMENTS IN CHILDREN Nutritional requirements may vary from one individual others and depends upon metabolic and genetic difference No single food meets all the essential requirements for children except mother's milk, which provides all nutritional substances to the infant till 6 months of age.
  • 7. • After wards healthy dietary habits depend upon cultural and influence and contribute to personal and social enjoyment So, to fulfil the nutritional requirements, child's diet should be planned by the parents and family members with different types of food items to provide balanced and nutritious diet.
  • 8. • The child's diet should contain sufficient amount of fluids calories, protein fats, carbohydrates, vitamins, minerals and salts to meet their daily nutritional needs. Food items should be digestible, palatable, attractive, choiceable and easily available.
  • 9. • Nutritional requirements should be maintained with margin of safety and with right balance. A deficit or excess in nutrients could be harmful and should be avoided. The 'recommended daily intake' of nutrients with sufficient amounts to be provided to maintain needs of the body and good health,
  • 10. Water Water is most important for maintenance of life. It constitutes about 70% of body weight in children. The total water content of the body is comparatively higher in infants than in adults. Water is required for digestion, metabolism, renal excretion temperature regulation, transportation of cellular substances, maintenance of fluid volume and growth of children.
  • 11. • The daily requirement of water is fulfilled by fluid intake, food and oxidation processes in the body. Water is absorbed throughout the intestinal tract. The balance of water depends on the protein & electrolyte intake, solute load, metabolic and respiratory rates and body temperature. Evaporation from the lungs & skin accounts for 40 to 50 % water loss & 3 to 10% by fecal loss.
  • 12. • The water and electrolyte balance by varying amount and concentration of urine. Excess loss of water can cause dehydration whereas an excess intake can result in water intoxication. Loss of water or dehydration is an important cause of death in children even than starvation. Water intoxication may found as edema, circulatory failure, abdominal distress or convulsions.
  • 13. • Calories The energy value of foods is measured in terms of 'large' calorie or kilocalorie. The production of energy varies during the oxidation of different foods. Children required more calories per kg of body weight than adults. Calorie requirements gradually decrease from infancy to adulthood. The average energy expenditure is 50% in basal metabolism 12% in growth, 25% for physical activity, 8% in fecal loss and 5% for specific dynamic action.
  • 14. • The calorie requirements of children depend upon body size and surface area, rate of growth, level of physical activity, food habits and climate. In a balanced diet, 50% of calories is provided by carbohydrates, 15% by proteins and 35% by fat. Deficiency of calorie intake leads to loss of weight, growth failure and protein-energy malnutrition. An excess intake of calorie results in increased weight gain and obesity.
  • 15. • Proteins Proteins are essential for synthesis of body tissues in growth, and during maintenance and repair. They help in the formation of digestive juices, hormones, plasma proteins, enzymes, hemoglobin and immunoglobulins. They are needed for maintenance of osmotic pressure and acid base equilibrium.
  • 16. • Proteins also act as source of energy, when the calorie intake is inadequate. Excess proteins, which are not used for building tissues or providing energy, converted by the liver into fat and stored in body tissues.
  • 17. • Proteins are made up of simpler substances called amino acids. There are 24 amino acids to be needed by the human body, of which '9' are called essential amino acids, because the body cannot synthesize them in amounts of their need and therefore must be supplied in the diet.
  • 18. • Both essential and nonessential amino acids are required for synthesis of tissue proteins. Proteins are obtained from two main dietary sources, i.e. animal origin and vegetable origin. Proteins of animal sources are biologically complete protein with all essential amino acids and more easily digestible.
  • 19. • Proteins of vegetable sources are incomplete and lack of one or more amino acids. The combination of vegetable proteins may provide all the essential amino acids. This is the reason that vegetarian diet should have mixing of 3 to 4 types of pulses or combination of wheat and legumes.
  • 20. • Protein requirements depend upon the age, sex, physical and physiological factors. It is found maximum in neonates and early infancy but gradually decreases as age increases. Extra amount of protein should be provided during illness to compensate the destruction or degeneration of body tissue, e.g. in blood loss, surgery, etc.
  • 21. • Deficiency of protein intake in food results in growth failure and protein-energy malnutrition.
  • 22. • Carbohydrates Carbohydrates are main source of energy and supply bulk in the diet. They contribute taste and texture of foods. They are digestion and absorption of other foods. carbohydrate intake in diet allows the use of protein for tissue synthesis, otherwise protein is also used for energy production and fat is metabolized with production of ketone bodies.
  • 23. • Excess carbohydrates are stored in the liver and muscle. Carbohydrates play an important part in infant nutrition as they spare proteins to be fully utilized for growth and various repair processes. Carbohydrates are consumed as monosaccharides (glucose, fructose, galactose), disaccharides (lactose, sucrose, maltose, isomaltose) and polysaccharides (starch, dextrin, glycogen, gum, fibers, cellulose).
  • 24. • All carbohydrates are ultimately oxidized and converts to glucose. Glucose is used as fuel by brain and muscle or converted to glycogen and stored in liver and muscle. Excess carbohydrates are converted to fat. The source of carbohydrate of infant's diet is in the form of lactose found in both human and cow's milk that should be provided up to 6 months.
  • 25. • Afterwards cereals, legumes, fruits, tubers, pulses and vegetables are the main sources. Lack of adequate carbohydrate intake may produce symptoms of starvation, under nutrition, constipation, fatigue, loss of body protein, ketosis, depression and carbohydrate malnutrition. Excess carbohydrate to obesity, ,ischemic heart disease etc .
  • 26. • Fat Fat supplies 40 to 50% energy needed for infant. It provides protection and support for organs and insulation of the body as adipose tissue. It acts as carriers of fat-soluble vitamins and components of cells and tissue. Fats and oils are concentrated sources of energy and make the foods palatable. Fats and oils are termed as lipids.
  • 27. • Lipids are classified as simple, compound and derived. Simple lipids are monoglycerides, diglycerides and triglycerides, which are combination of glycerol and fatty acids. Compound lipids are combination of simple lipids with nonlipid substance such as glycolipids, phospholipids and lipoproteins.
  • 28. • Fats are available from both animal and vegetable sources. About 98% of neutral fats are triglycerides and other 2% include free fatty acids, monoglycerides, diglycerides, cholesterol and phospholipids. Fatty acids are divided into saturated and unsaturated fatty acids, which are further divided in monounsaturated and polyunsaturated fatty acids. Polyunsaturated fatty acids are mostly available in vegetable oils and the saturated fatty acids available in the animal oils.
  • 29. • Exceptionally, fish oils contain poly and monounsaturated fatty acids whereas coconut and palm oils have extremely high percentage of saturated fatty acids. Essential fatty acids are those that cannot be synthesized in the human body and should be derived only from food. The most essential fatty acid is linoleic acid, which is abundantly available in vegetable oils.
  • 30. • It helps in maintenance of good health. Saturated fat should not be more than 10% of total fat intake. More fat intake in diet may results in indigestion as it remains longer in the stomach.
  • 31. • Excess fat intake leads to excess accumulation of adipose tissue, obesity, NIDDM, cancer, atherosclerosis and hypertension. Deficiency of all essential fatty acids may result in growth retardation and skin disorders, susceptibility to infections, neurological and visual problems and decreased myocardial contractility. The ICMR has recommended a daily fat intake of 25 g/ day in young children and 22g / day in older children.
  • 32. • Vitamins Vitamins are organic substances and essential micronutrients for maintenance of normal health. They are available in many foods in small amounts. . Balanced diet supplies all the vitamins needed for a healthy individual. Vitamins act as cofactor in many enzyme systems and essential for energy production, hemopoiesis, reproduction, neurological functions, hydroxylation and synthesis of fats, amino acids, nucleic acids and nucleoprotein. They enable the body to use other nutrients and help in maintenance and protection of good health.
  • 33. • Vitamins are classified into two groups, i.e. fat-soluble and water-soluble vitamins. Fat- soluble vitamins are linA, D E and K. They are stored in body fat and needed only in minimal amount in daily diet. Excess intake of these may produce toxic effects. The water-soluble vitamins are vitamin B and C. They are not stored in the body and required in adequate amount in daily diet to prevent deficiency conditions.
  • 34. • Water soluble vitamins are easily destroyed during food processing, preparation and storage. Each vitamin has a specific function to perform and deficiency of any particular vitamin may result in specific deficiency
  • 35. • Many factors are responsible for the vitamin deficiency conditions. They include poor dietary intake, faulty absorption, increased loss in chronic diarrhea, greater demand during fever, infections and metabolic diseases and poor utilization in chronic liver diseases.
  • 36. • Vitamin requirements are more in preterm babies. Infants get adequate vitamins from mother during lactation. Dietary intake of vitamins may be low or marginal during infancy and childhood. The minimum intake for the maintenance of health in respect of many of the vitamins has been determined.
  • 37. • Minerals Minerals are inorganic elements, required by human body for growth, repair and regulations of vital body functions. They act as catalysts in biochemical reactions. More than 50 minerals are found in the human body, all of which must be derived from foods. A well- balanced diet supplies sufficient quantities of minerals.
  • 38. • Minerals are required for maintenance of osmotic pressure, supply of necessary electrolytes for the actions of muscles and nerves and for hemopoiesis. Minerals are classified as macrominerals when the daily requirement is 100 mg or more and as microminerals when less than 100 mg is required daily.
  • 39. • Macrominerals are calcium, phosphorus, sodium, potassium and magnesium. Microminerals or trace elements required by the body in quantities of less than few mg per day and include iron, iodine, fluorine, zinc, copper, cobalt etc
  • 40. • Minerals deficiencies are less among vegetarians than nonvegetarians. Adequate amount of protein in daily diet prevents minerals deficiencies.
  • 41. Conclusion • The health and nutritional status of an infant and subsequent growth and development through childhood depend upon successful feeding practices. The socioeconomic status and education of the mother and family members have been known to influence child's feeding behavior. Nutritional counseling is the important responsibility of the nurse to promote the nutritional status of the children and to prevent nutritional deficiency diseases.