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Children and adolescents form the backbone of future generations and their health and nutrition play a significant role in human resource development. In modern times, children in developing countries are exposed to poverty, unstimulating home environments, malnutrition, and other risks, and this affects their growth, development and overall health1. India is a lower-middle-income country facing these problems, and more than 40% of Indian children are stunted2. In spite of poverty alleviation and improved food availability, malnutrition and related health problems are increasing among Indian children3. In India, malnutrition is a problem of multiple dimensions — social, cultural economic, health, educational and nutritional4. India has 1.5 to 2 times stunting and wasting rates compared to global average5. Thus, meeting nutritional needs for Indian kids is essential to bridge the gap of growth milestones.
The purpose of Recommended Daily Allowances (RDA) is to quantify the specific nutrients the body needs on daily basis. Across countries, the RDA and predominant diets are different and are highly related to the overall growth and development of children. For example, the RDA for protein consumption among 4- to-6-year-old Indian children is 20.1 g/day while for American boys of the same age group, it is 19 grams of protein on daily basis.
The food habits of children in the United States, Canada, South Korea, Western European nations and other non-third world countries develop under conditions like dietary abundance and availability of inexpensive and ready-to-eat foods that are readily available. They have exposure to large portions of energy-rich foods, and an increased proportion of foods that they eat is consumed away from home10. In India, population explosion, demographic changes and alteration in traditional food habits have led to development of unhealthy eating practices among children, resulting in malnutrition and diet-related chronic diseases9. Myriads of attractions about fast food/junk food float around in electronic and social media which are influencing the food habits of Indian children, particularly in urban population groups. While in India unhealthy lifestyle factors, such as unwholesome food choices have led to inadequate consumption of nutrients by children, children in Western countries are moving towards consumption of 3 meals plus 3 snacks per day, experiencing an increase in snacking behavior11.
The dietary patterns in India are diverse. However, the food intake patterns of Indians indicate that most Indian children follow a vegetarian diet and even then, they consume vegetables, fruits, nuts, animal foods and other sources of micronutrients less frequently12. National Nutrition Monitoring Bureau (NNMB) surveys have also shown that except cereal and millets, consumption of all foods in Indian households is lower that the RDA. Intake of pulses and legumes which are important for protein ingestion was found less than 50% of RDA7. As a result, only 20.3% of pre-school children are found nutritionally normal, while the others suffer from mild, moderate, or severe malnutrition12. Improper dietary habits and replacement of traditional home-cooked meals with ready-to-eat, processed foods has contributed to poor nutrition intake in Indian children. Junk food consumption has dramatically increased in India and tends to be associated with a reduced intake of nutrients (calcium, fiber and vitamins and minerals that fruits and vegetables provide) and excess intake of sugar, saturated and trans fat , sodium and other nutrients that children need in less quantity13. The omission of a variety of healthy foods from their daily diets and frequent consumption of energy-dense, nutrient-poor foods and sugar-sweetened beverages is putting India children at risk of developing chronic degenerative diseases14. Compared to children in the West, Indian children consume diets that are typically higher in carbohydrates and lower in proteins15.
The nutritional status of children is expressed as the proportion of weight for age, height for age, or weight for height. For growth and assessment of children below 5 years, IAP (Indian Academy of Pediatrics) recommends the use of WHO standards. However, to supersede the previous charts, IAP growth chart committee recommends revised growth charts for height, weight and BMI assessment of growth of 5-18 years old children in India. This is because it was observed that all children grow at a consistent pattern up to the age of 5 years. However, the trajectory of growth of Asian children including Indians is different during their pubertal years. CDC growth charts for 5-18 year olds are based on statistical reconstruction of 1977 National Centre for Health data on American Children. Also, in developing countries, there have been secular trends in childhood growth. As a result, construction of new growth charts is inevitable. Ideally, prevalence estimated as per new Indian IAP charts should be used as these cut-offs are comparatively more appropriate than the ones shown by CDC for Asian Indian children16.
Comparing the IAP and CDC growth charts for height, weight and BMI of children, it has been found that Indian children are shorter and lighter than their Caucasian counterparts.
Adequate intake of food and regular nutrition habits are the crucial factors for maintenance of general health status in children. Currently, most of the world’s population, including Indians, have dietary intakes which are much lower than the RDA. India is still home to the highest number of stunted children in the world. To achieve proper growth and development, babies should be breastfed exclusively for the first six months of life. Soon after the baby completes six months, complementary foods rich in nutrients should be introduced and breastfeeding should be continued3.Healthy eating practices should be encouraged in early childhood and a variety of foods should be incorporated into their diet to ensure optimum nutritional intake7.
The universally accepted definition of dietary fibers “Dietary fiber is a type of carbohydrate that cannot be digested by our bodies enzymes”. Fiber is a very important non-nutrient. Foods rich in fiber improves satiety as it needs more clearing than other foods and it absorbs water and swells
By:- Dr. Anuradha Khadilkar and Dr. Vaman Khadilkar HCJMRI, Jehangir Hospital, Pune
Calcium and vitamin D are critical for musculosketal health. One of the main actions of Vitamin D is for the absorption of calcium. The calcium that is absorbed is deposited in bones;
Dual protein combinations containing a blend of soy and dairy proteins (whey and casein) have sufficient essential amino acid content, various digestion rates and longer aminoacidemia compared to single protein isolates to offer unique advantage to health.
It is a well known fact that children are a vulnerable segment of population and also very susceptible to morbidity due to infections. Various short term and long term health outcomes are associated with under-nutrition such as impaired immune
Optimal nutrition intake is necessary for normal brain development.1 According to the UNICEF, the years from conception through birth till the age of eight years is a critical period for complete and healthy cognitive, emotional and physical growth of children.
Dr. Meghna Chawla DNB (Paediatrics), Fellowship in Paediatric Endocrinology (UK) Consultant Paediatric and Adolescent Endocrinologist, Ruby Hall Clinic, Pune Assistant Professor and In-charge, Paediatric Endocrine Clinic, SKN Medical College, Maharashtra
The information and references in this article are intended solely for the general information and do not constitute legal or other professional advice on any subject matter. The information contained herein is correct as the date of this document to the best of our knowledge. We suggest that you evaluate any recommendations and suggestions independently. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as referred in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended that require medical treatment under a doctor's care.The content of this article is not intended to offer personal medical advice, diagnose health problems or for treatment purposes. It is not a substitute for professional medical advice. Please consult your health care provider for any advice on medications. These articles have been created and curated by Signutra’s medical team and are property of the Company. Copyright of these articles vests with Company.