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Good nutrition and child health-the role of parents

By G.D. Zaney

Good nutrition is essential to good human health from gestation, through infant to young child and adult, and it is a healthy child who grows into a healthy adult.

 


Research results from the Children's Nutrition Research Center (CNRC) have established that metabolic, hormonal and dietary factors affect the body's absorption and utilization of essential mineral nutrients in children.

 


Available research evidence indicates that the inadequate intake of dietary nutrients like folic acid, Vitamin A, protein and cholesterol during critical periods of development exerts permanent effects on the development of specific organs, such as the brain, as well as increased health risks such as obesity, heart disease, cancer and osteoporosis in adulthood.


Dietary components, no doubt, help determine organ growth, development and function from gestation, through infancy and childhood to adolescence. In other words, nutrition is important to the physical and mental development of children who will then grow into healthy adults.


Childhood is, therefore, the best time to practise healthy eating habits, that is to say, child nutrition is not limited to newborn babies, but also covers nutrition during pregnancy- research having established that the optimal dietary energy, protein and mineral intakes are necessary for maternal health during pregnancy and lactation as well as for the wellbeing of infants and children.


According to the United Nations Organization (UNO) and the World Health Organization (WHO), more than two billion people across the globe-mostly young children (at least half of the world’s children aged between the ages 6 months and 5 years) and women of child-bearing age - suffer from deficiencies in micronutrients such as iron, iodine, vitamin A, folic acid and zinc,


Micronutrients are nutrients required by organisms throughout life in small quantities to orchestrate a range of physiological functions. For persons, they include dietary trace minerals in amounts generally less than 100 milligrams/day - as opposed to macro minerals which are required in larger quantities.


The micro minerals or trace elements include at least iron, cobalt, chromium, copper, iodine, manganese, selenium, zinc and molybdenum. Micronutrients also include vitamins which are organic compounds required as nutrients in trace amounts.


Iron, the Global Report 2009 indicates, is an essential mineral critical for motor and cognitive development, yet it is children and pregnant women, the poor and least educated whose diets lack iron and are, therefore, especially vulnerable to low haemoglobin concentration (anaemia) during pregnancy which increases the risk of low birth weight, maternal, prenatal and neonatal mortality of between 2.5 million and 3.4 million globally. The Lancet Global Health, Volume 1, puts the number affected globally by anaemia at 43 per cent of children 5 years of age and 38 per cent of pregnant women.


Preventing iron deficiency, therefore, helps improve children's learning ability and cognitive development while, on the other hand,  long-term iron deficiency may result in impaired mental development in children, decreased physical work capacity and impaired immune function, with young children and pregnant women being particularly vulnerable as they require higher levels of the mineral for growth.


It is for this reason that WHO has recommended iron and folic acid supplements for reducing anaemia and improving iron status among women of reproductive age. Indeed, according to the Copenhagen Consensus 2012, flour fortification with iron and folic acid is globally recognized as one of the most effective and low-cost micronutrient interventions.


Another important micronutrient is iodine, which is required by the foetus for brain and cognitive development, the Lancet Global Health, Volume 1, again indicates.
While Global Report 2009 puts the figures at 18 million for babies born mentally-impaired because of maternal iodine deficiency and 38 million born at the risk of iodine deficiency, the Endocrine Review of June 2009 says insufficient iodine intake accounts for an estimated 2 billion people, globally.


Thus according to the Nutrition  Review 2012,  the most successful nutrition interventions lie in the fortification of salt with iodine, with the Global Report, 2009 confirming that salt iodization has led to an increase in Intelligence Quotient (IQ) points and significant decline in the prevalence of iodine deficiency disorders, such as goitres.


Vitamin A, UNICEF‘s Global Progress Report of 2013 indicates, is another key micronutrient which ensures healthy eyesight and the effective functioning of the immune system. In other words children who are deficient in Vitamin A face an increased risk of blindness and death from infections such as measles and diarrhoea.


UNICEF ‘s Global Progress Report of 2013 further states that globally, 1 in every 3 pre-school-age children and 1 in 6 pregnant women are vitamin-A-deficient due to inadequate dietary intake.


The WHO Guideline: Vitamin A supplementation for infants and children 6-59 months of age, therefore, recommends vitamin A supplementation of children 6 to 59 months which has been shown to be highly effective in reducing mortality from all causes in countries where vitamin A deficiency is a public health concern.
Zinc, a micronutrient or mineral that strengthens immunity, resistance to infection and the proper growth and development of the nervous system, is integral to healthy pregnancy outcomes.


However, Global Report 2009 indicates that 17.3 per cent of the global population is at risk for zinc deficiency due to dietary inadequacy, while in some parts of the world, up to 30 per cent of people are at risk. Zinc, the report says, reduces the incidence of premature birth, decreases childhood diarrhoea and respiratory infections, lowers all-cause mortality and increases growth and weight gain among infants and young children. Zinc supplementation has, therefore, been strongly recommended.


Global Report 2009 also identifies folic acid as a vitamin essential in the earliest days of foetal growth for healthy development of the brain, spinal cord, and skull. The Report indicates that ensuring sufficient levels of folic acid in women prior to conception can reduce neural tube defects (a serious birth defect) by up to 50 per cent and recommends that supplementation of women 15-49 years with folic acid, and fortification of foods such as wheat flour with folic acid, are effective interventions for the reduction of birth defects, morbidity and mortality in newborns.


Going by the various reports, it is gathered that not only have deficiencies in micronutrients and the accompanying health effects become a global challenge, but also that awareness of the need for healthy eating-eating a variety of foods and in the right amount every day- is lacking.


At the 1990 World Summit for Children, two microminerals and one micronutrient - iodine, iron, and vitamin A - were identified as being particularly common and posing public health risks in developing countries.


The Summit, therefore, set goals for elimination of these deficiencies while the Ottawa-based Micronutrient Initiative was formed in response to this challenge with the mission to undertake research and fund and implement micronutrient programming.


The response to the challenge, therefore, is to produce fortified, affordable and nutritious foods and beverages in areas with high risk of deficiencies, and sensitize the public to appreciate the importance of healthy eating, while children should be encouraged to eat balanced diets as they stand to gain the most.


Fortunately, in Ghana, Nestle Ghana is in the forefront of efforts at producing the needed foods and beverages which are nutritious and well-fortified.


Also key to efforts at addressing the challenge of eliminating micro-nutrient deficiencies and growing healthy children into healthy adults are parents whose support and guidance is indispensable.


Apart from patronizing Nestlé products, parents are encouraged to feed their children with poultry, fish, lean meat, consisting of broiled, baked, or roasted and not fried as well as soft margarine, instead of butter, low-fat dairy products and low-saturated fat oils from vegetables, while  limiting egg  consumption.


Parents are also encouraged to serve their children foods low in salt, researchers having found a relationship between dietary salt and high blood pressure with accompanying risk of heart attacks and strokes.


It is recommended that salt added to food during preparation be minimized, using herbs, spices, or lemon juice instead and that the salt shaker should be taken off the dinner table, or its use considerably limited.


According to dieticians and nutrition experts, fat is an essential nutrient for children and should not be severely restricted as fat supplies the energy, or calories, children need for growth and active play.


The caution, however, is that there are dangers in high fat intake. For example, a diet high in saturated fats - usually solid at room temperatures and found in fatty meats, such as beef, pork, ham, veal, and lamb, and in many dairy products, such as whole milk, cheese and ice cream - can cause health problems, including heart disease later in life.


The dietary and nutrition experts have, therefore, recommended that after the age of two, children should be served foods that are lower in fat and saturated fats.


According to the American Academy of Pediatrics, healthier, more low-fat, low-cholesterol foods are recommended for children over the age of two and that  fats should make up less than 30 per cent of the calories in a child’s diet, with no more than about one-third or fewer of those fat calories coming from saturated fat and the remainder from unsaturated - polyunsaturated or monounsaturated - fats, which are liquid at room temperature and include vegetable oils like corn, safflower, sunflower, soybean, and olive.


Sugars in foods, whether natural or added, provide caloriesthe fuel that supplies the energy necessary for daily activities, but too much sugar means too many calories, according to nutrition experts.


Parents, the experts say, should, therefore, keep in mind that calories from sugar can quickly add up and, over time, lead to weight gain and the development of tooth decay.


Parents are encouraged to ensure that their children eat breakfast which has been associated with improved overall nutrition for children, resulting in better memory, better test scores, better attention span to decreased irritability and healthier body weights.


The responsibility placed on parents demand that parents think of their nutritional decisions as health decisions, adopt healthier habits and, in effect, avoid or lessen long-term health problems linked to poor nutrition.


The writer is an officer of the Information Services Department.

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