What Nutritional Problems can Affect Children?
Good nutrition is essential for all children to achieve their physical and developmental potential. Children with special health care needs are at increased risk for nutrition related problems because of:
- Physical disorders or disabilities that may affect their ability to consume, digest, or absorb nutrients
- Biochemical imbalances caused by long-term medications or internal metabolic disturbances
- Psychological stress from a chronic condition or physical disorder that may affect a child's appetite and food intake
- Environmental factors that may influence a child's access to and acceptance of food
There are many things that can go wrong with a child's nutrition. The following are just some of the more common issues that may arise.
Healthy Snacks and Re-hydration
To meet nutrient requirements, children need regular meals and snacks. Snacks provide a half to a third of the energy intake for most children. Snacking has been shown to improve attention, recall, even arithmetic problem solving, in some studies – this may also be true of parents and their eating patterns. Athletic children have high energy and carbohydrate requirements. Meeting these needs is also important for enhancing sports performance.
Effective rehydration is also a key strategy for safe and optimal performance. Children rarely drink enough to replenish fluid losses and need to learn to consume more than thirst dictates. While water is often described as the best choice of fluid, there are situations when sports drinks are advantageous for rehydration after playing sports or other intense physical activity. Also important to note here is to stay away from carbonated soft drinks and sugary drinks for re-hydration.
Some of the other nutritional concerns in childhood that occur are:
Underweight
There can be several reasons that result in underweight status, the most common being an illness, poor nutritional intake, and poor appetite. It can also be due to food deprivation. This condition can be corrected by providing sufficient energy and nutrient intake.
Malnutrition
Malnutrition simply means a state of poor or inappropriate nutrition. In the developing world, the word malnutrition conjures up a picture of a grossly underweight or wasted child. Such a child is markedly underweight for their age, as well as for their height. The child is said to have malnutrition and the disease state is called wasting. If the state of malnutrition persists for an extended period of time, the height of the child will also be affected. This gives rise to the disease state of short stature or nutritional stunting.
Obesity is the result of malnutrition where a child is getting many more calories than their bodies require and often from poor sources i.e. foods are not nutrient dense. It can result in a myriad of negative effects on the cardiovascular system, hormone balance, joints, etc and symptoms and secondary conditions will vary with other nutrient deficiencies and toxicities related to the specific diet of the child.
Anaemia or Iron deficiency
As children grow, there is an increased requirement of iron. Most often, children tend to have low intakes of dietary iron and hence develop anaemia. This can be prevented by including good sources of iron such as meat, poultry, fish etc in the diet. Also important is the inclusion of Vitamin C or ascorbic acid in the diet as it helps to absorb iron from non-heme sources such as spinach or other vegetables. Iron toxicity is rare in children, unless there is an underlying medical condition. Girls entering puberty need to be particularly concerned with obtaining adequate iron.
Dental Issues
High sugar foods and poor oral hygiene are most likely to lead to dental cavities in children. Limiting intake of desserts and other cariogenic foods and developing good brushing habits early in life along with a fluoride supplement can help avoid this problem. Dental caries can lead to tooth damage, which can require drastic medical intervention that is often very painful.
EATING DISORDERS
Body image, dieting, and eating disorders play a significant part in the lives of many young people today. Eating disorders such as Anorexia Nervosa and Bulimia have increased in the last decades as ideal images of how women and men should look and what the media sees as ideal body images. These unrealistic portrayals of the “ideal image” have programmed unhealthy ideals of the child and adolescent population. These two eating disorders are more common in young girls than boys, however the number of boys developing the conditions is increasing, while the average age of sufferers continues to decrease.
Anorexia Nervosa is a wasting condition caused by the purposeful restriction of calories to a level insufficient to support the energy requirements of the body. Calorie intake is typically extremely low resulting in dramatic weight loss, along with symptoms of severe nutrient deficiencies (weak bones, muscle twitching, poor immune system function, muscle wasting, mental abnormalities including paranoia, depression, anxiety etc). It is characterised by a skeletal appearance, the growth of fine downy hair on the body known as lanugo and a distorted perception of body size. An unusually small appetite, hiding of food, sudden weight loss, excessive exercising, irritability, and girls may experience a cessation of the menstrual cycle.
An anorexic can see their reflection in the mirror, and still believe they are overweight. Anorexics typically require both counselling and hospitalisation to gradually increase their weight, help correct the underlying psychological issues and ensure a balanced, nutritionally adequate diet is achieved and maintained. Some anorexics will eventually die of the condition and it should never be taken lightly. Anorexics may deprive themselves of food in order to feel a sense of control over their lives, to punish themselves or because they believe they are ugly, overweight, or somehow worthless or useless.
Bulimia nervosa is a distinct eating disorder, which may manifest for the same reasons as anorexia. However, instead of starving themselves, bulimics binge eat and then purge, by self-induced vomiting. Like anorexia, the sufferer will display symptoms of severe nutrient deficiency and rapid weight loss. They will also tend to have poor breath, and can cause damage (typically ulceration) to their oesophagus and mouth due to the acidic stomach contents being regurgitated regularly. Their teeth can also be severely damaged.
Binge eating periods are generally a complete loss of control, and this is followed by a self-loathing in the person’s lack of control, resulting in the purging of food. Like anorexics, bulimics will generally have very low self-esteem and a completely distorted perception of their body size and shape. Signs of bulimia include secretive eating habits, disappearing after meals, rapid weight loss, excessive exercising, irritability and in girls the menstrual cycle may cease.
Some of the other common childhood nutrition problems seen in the world include:
- Delayed growth, underweight and overweight
- Feeding delays, oral-motor problems, or altered feeding interactions
- Inadequate or excessive diet quantity or quality
- Medication/nutrient interactions
- Elimination problems, i.e. constipation, diarrhea
- Altered energy and nutrients needs, i.e. inborn errors of metabolism
- Poor or excessive appetite
- Children eating vegan diets that do not get the right amount of nutrients
