Good nutrition for children is essential to achieve their full developmental potential. Undernutrition has critical consequences for physical and cognitive growth and development. Malnutrition leads to failure in early physical growth, delayed motor skills, cognitive and behavioural development; it diminishes immunity and increases morbidity and mortality. Those children who survived malnutrition in early childhood have disadvantages compared to those who have had adequate nutrition and a healthy living environment.
Causes Of Undernutrition For Children
Under nutrition is associated with shorter adult height, less schooling, and reduced economic productivity and women’s offspring can have lower birth weights. Under nutrition in childhood has also been associated with an increased risk of developing metabolic syndrome and cardiovascular disease, systolic hypertension, obesity, insulin resistance, and diabetes in adulthood. Malnutrition in childhood includes diminished intellectual performance, low work capacity, and increased risk of delivery complications—deficiencies, together with stunting, limit children’s ability to realise and achieve their potential.
Physical Effects
Inadequate nutrition for children during infancy, childhood or adolescence can restrict growth; weaken immunity, and increase infections and diseases. Undernutrition begins with conception itself due to maternal undernutrition. It can lead to the delivery of low birth-weight babies.
In India, almost 1% of preschool children suffer from severe forms of protein-energy malnutrition. Sub-clinical undernourishment is prevailing in almost half of the 5-year-old children with underweight symptoms, stunting and wasting. Poor or insufficient diet can cause catabolism of body tissues and failure to provide energy substrate. Continuous undernutrition in the childhood years leads to short stature in adults.
Effect on the Nervous System
The central nervous system is most susceptible to nutritional impact during the 3rd trimester of pregnancy until two years of age. Diet has a dual role in cognitive development:
• It provides substrates from which the brain has been constructed.
• It provides energy for the adequate functioning for the brain.
Both intrauterine and extra-uterine malnutrition have the great impact on brain function and brain structure composition. The bad effects of malnutrition on the brain at early life include decreased brain cells, a number of synapses, dendritic arborisation and myelin production, leading to smaller brain size and neurotransmitter changes systems. The hippocampus, cerebellum and neocortex are the affected brain parts. All these changes are associated with:
• Delay in cognitive and motor functions
• Impaired school performance
• Poor memory
• Learning disorders
• Reduced social skills
• Lower IQ scores
The nutritionally adequate and balanced diet is to prevent those mentioned above physical and psychological ill-effects and for the optimum growth, development, and boosting of children’s immune function.
Problems for Not Having Proper Nutrition for Children
The following are some commonly found problems due to lack of nutrition for children:
• Child Malnutrition
Child malnutrition is one of the biggest issues in India. Almost one child out of six does not have enough food to lead the healthy and active life. On a global level, hunger and malnutrition represent the primary risk for individual health—worse than the combined effect of diseases such as AIDS, malaria and tuberculosis. The main reasons that can be traced are poverty, war, natural disasters, inadequate or scarce infrastructure and farming equipment, and overexploitation of the environment. Also, the combined effect of the economic, financial crisis and food crisis has further complicated this scenario, contributing to an increase in the number of malnourished individuals.
• Child Malnutrition
Malnutrition causes 9.7 million deaths recorded in children less than five years of age in developing countries. The children below the age of 5 years are underweight in India due to an acute or chronic food shortage. The child malnutrition is inherited often from poor maternal diet, both before and during pregnancy. In fact, children are born underweight each year; newborns who survive despite low birth weight tend to suffer from retarded/limited growth and cognitive development, and are more susceptible to infectious diseases, both during childhood and adolescence, up through reaching adulthood. There is the connection between malnutrition in early years, including the period of pregnancy, and subsequent development of chronic diseases such as diabetes, high blood pressure and heart disease.
• Childhood Obesity
In children, overweight and obesity have resulted in a series of physical and psychological consequences that can be so serious that they manifest themselves in childhood. The most frequent consequences of childhood obesity are both metabolic (glucose intolerance, high blood pressure) and non-metabolic in nature, such as osteoarticular (articular pain, reduced mobility, flat feet), and psychological pathologies (poor body image, eating disorders, depression). Obesity involves emotional, social and psycho-social consequences that are significant for children and adolescents.
This childhood obesity, in turn, out to be the risk of depression and anxiety. In addition, overweight children have lower self-esteem and are more likely to decrease their social and psychological development. They have lower self-esteem; they are more susceptible to behaviour with a negative health impact, such as drinking and smoking. In addition, children who have been overweight/obese are more susceptible to cardio-circulatory (high blood pressure, heart disease), muscular-skeletal (early development of arthritis due to static-dynamic stress) and cancer of the gastrointestinal tract.
• Child Emotional Stress
Emotional stress is associated with food fads and weight-loss trends, especially in girls, which can lead to a relationship with food that is not serene and balanced. Also, the overweight and obesity in adolescents constitute a serious nutritional problem that tends, with high probability, to carry over into adult life. Obesity in adolescence is connected with metabolic diseases and in adulthood with higher mortality rates.
Children are facing emotional stress because of lack of energy and specific nutrients which they require. The stress and emotional anxiety typical of the adolescent years can negatively impact teenagers’ nutritional equilibrium, resulting in insufficient or excessive food consumption. In addition, infections, emotional tension, menstruation and teeth or skin problems can influence appetite and increase the vulnerability of adolescents whose diet must be such as to properly meet the caloric demands of their bodies.
Importance of Nutrition for Children
• For good health & body development during the early years of life, it is important to have proper nutrition for children.
• In case children do not eat the right amount of macronutrients such as protein, fat, and carbohydrates and micronutrients such as vitamin A, iodine, iron and zinc, in that scenario they can become ill or may develop mental health issues.
• Optimal nutrition and correction of nutritional deficiencies during the early years are of particular significance as beyond two years of age, and a reversal can become very difficult.
• However, WHO and UNICEF developed the Global Strategy for Infant and Young Child Feeding to improve children’s development, health, and survival through optimum feeding practices.
Nutritional Requirements for Growing Children
Macronutrients
• Carbohydrates
A major energy source for all cells is carbohydrates, which are the primary source of energy for erythrocytes and the CNS. Complex instead of simple carbohydrates will contribute to a greater extent in the diet.
The higher intake of sugars in children can displace essential macro and micronutrients, thereby increasing the risk of nutrient deficiencies. Fruits consider to be a good source of simple carbohydrate and are also rich sources of vitamins and fibre. Whole fruits instead of fruits juices must preferably be given to children.
• Proteins
Protein-energy malnutrition hampers brain, immune system and intestinal mucosal functions. Protein requirement is necessary for infants and growing children than for adults. All the essential amino acids must be provided through dietary intake. For children who are vegetarians a variety of food sources, including legumes and corn, must be incorporated to meet the requirement of essential amino acids.
Breast milk is considered a good source of proteins for infants. For children and adolescents, milk is an important source of good quality proteins in addition to other animal and vegetables food sources. Overall, for children, almost 10% to 35% of total calories will come from proteins.
• Fats
In addition to being energy-dense, fats provide essential fatty acids and have important structural and functional roles. Fatty acids are needed for the development of nervous system myelination in younger children less than two years of age. Fats also facilitate absorption of fat-soluble vitamins.
The functions of fats are important for neurological and ocular development. For children younger than two years, 25% to 40% of total calories will come from fat, and for older children, 10% to 35% calories will come from fat.
• Micronutrients
• Calcium
In the childhood and adolescence, adequate calcium intake is important for bone development during growing years and later years of life. The dairy products such as milk are a good source of calcium. However, recommended dietary allowances for calcium are about 600 to 800 mg/d, higher calcium intakes during adolescence help to achieve peak bone mass.
Children who do not consume an adequate amount of milk products, calcium requirements can be met by the other sources such as tofu, green leafy vegetables, ragi, sesame seeds and calcium-fortified food products.
• Iron
Iron deficiency is another very common problem among children and is associated with anaemia and neurocognitive deficits. Iron present in the animal food source is more bioavailable than that are present in plant sources. Vitamin C rich foods can promote the absorption of iron in the body.
• Vitamin A
Vitamin A is also very important micronutrient as it is required for clear vision in dim light and maintenance of epithelial tissues’ integrity. It plays a role in maintaining resistance against common infections. Orange, yellow, and dark green fruits and vegetables are rich sources of beta-carotene, which is the precursor of retinol.
• Vitamin D
Vitamin D is critical for calcium and bone metabolism, and its adequate intake is very important for long-term bone health. In infants, the deficiency of vitamin D can cause rickets, and other severe deficiency can lead to hypocalcemic seizures.
