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Chapter 12

NUTR2050 Chapter 12: Nutrition Chapter 12


Department
Nutrition
Course Code
NUTR 2050
Professor
Simone Holligan
Chapter
12

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Nutrition Chapter 12—Child and Preadolescent Nutrition
Introduction
Children continue to grow physically at a steady rate during this period, but development from a
cognitive, emotional, and social standpoint is tremendous. This period in a child’s life is
preparation for the physical and emotional demands of the adolescent growth spurt.
Definitions of the Life Cycle Stage
Middle childhood is a term that generally describes children between the ages of 5-10 years.
Preadolescence is generally defined as ages 9-11 years for girls and ages 10-12 years for
boys.
Importance of Nutrition
Adequate nutrition continues to play an important role during the school-age yeas in ensuring
that children reach their ful potential for growth, development, and health. Therefore, adequate
nutrition and the establishment of healthy eating behaviours can help to prevent immediate
health problems as well as promote a healthy lifestyle, which in turn may reduce the risk of the
child developing a chronic condition such as obesity, type 2 diabetes, and/or cardiovascular
disease later in life. Adequate nutrition, especially eating breakfast, has been associated with
improved academic performance in school and reduced tardiness and absences. On the whole,
non-Hispanic White and Asian Pacific Islander children have better child well-being outcomes
compared with the other large racial and Hispanic origin groups. The environment in which a
child lives affects the child’s health status, including nutrition. Lack of transportation is a
significant limitation for many families. Disparities in nutrition status indicators exist among races
and ethnicities.
Healthy People 2020
Table 10.1 & Table 12.1—page320
Normal Growth and Development
During the school-age years, the child’s growth is steady, but the growth velocity is not as great
as it was during infancy or as great as it will be during adolescence. The average annual growth
during the school years is 7 pounds in weight and 2.5 inches in height. Children of this age
continue to have spurts of growth that usually coincide with periods of increased appetite and
intake. During periods of slower growth, the child’s appetite and intake will decrease. Children
should continue to be weighed on calibrated scales without shoes and in lightweight clothing.
The child’s stature or standing height should be measured without shoes and utilizing a height
board.
The 2000 CDC Growth Charts

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The growth charts, which are pertinent to the school-age child, cover weight-for-age, stature-for-
age, and body mass index. Gender-specific BMI-for-age values greater than or equal to the 85th
percentile but less than or equal to the 94th percentile defines overweight, while BMI-for-age
values greater than or equal to the 95th percentile define obesity. As with the toddler and
preschooler, it is the child’s pattern of growth over time that is important rather than any single
measurement. The 2007 curves were matched to the WHO under-five curves and BMI values at
age 19 years compare to the BMI cut off used for adults for identifying overweight and obesity.
Physiological and Cognitive Development of School-Age Children
Physiological Development
During middle childhood, muscular strength, motor coordination, and stamina increase
progressively. Children are able to perform more complex pattern movements. During the early
childhood years, percent body fat reaches a minimum of 16% in females and 13% in males.
Percent body fat then increases in preparation for the adolescent growth spurt. This increase in
percent body fat, which usually occurs on average 6.0-6.3 years of age, is called BMI rebound
and is reflected in the BMI for-age growth charts. The increase in percent body fat with puberty
is earlier and greater in females than in males (19% for females vs 14$ for males). During
middle childhood, boys have more lean body mass per centimeter of height than girls do.
With the increase in body fat, preadolescents, especially girls, may be concerned that they are
becoming overweight. Parents need to be aware that an increase in body fat during this stage is
part of normal growth and development. Parents need to be able to reassure their child that
these changes are most likely not permanent; parents also need to be careful not to reinforce a
preoccupation with weight and size.
Cognitive Development
The major developmental achievement during middle childhood is self-efficacy, the knowledge
of what to do and the ability to do it. During the school-age years, children move from a
preoperational period of development to one of “concrete operations”. This stage is
characterized by being able to focus on several aspects of a situation at the same time; being
able to have more rational cause/effect reasoning; being able to classify, reclassify, and
generalize; and a decrease in egocentrism, which allows the child to see another’s point of view.
During this stage, the child is developing a sense of self. Peer relationships become
increasingly important, and children begin to separate from their own families. Thus, influences
outside the home environment play an increasing role in all aspects of the child’s life.
Developing of Feeding Skills and Eating Behaviours
Eating Behaviours: Parents and older siblings continue to have the most influence on a child’s
attitudes toward food and food choices during middle childhood and preadolescence. Parents
are responsible for the food environment in the home, what foods are available, and when they
are served. The child is responsible for how much she eats. Parents need to continue to be

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positive role models for their children in terms of healthy eating behaviours. They also need to
provide the necessary guidance to that the child will be able to make healthy food choices when
away from home.
Family Mealtime: Families should try and eat meals together. Also allowing time for
conversation is important too. Children who ate dinner with their families had higher energy
intakes as well as higher intakes of nutrients such as fiber, calcium, folate, iron, and vitamins
B6, B12, C and E. These children also reported eating more fruits and vegetables, eating fewer
fried foods when away from home, and drinking fewer soft drinks. The percentage of children
who reported eating family dinner decreased with the age of the child, indicating that family
dinner becomes more of a challenge as children get older.
Outside Influences: Peer influences becomes greater as the child’s world expands beyond the
family. The increased peer influence extends to attitudes toward foods and food choices.
Teachers and coaches have an increasing influence on the child’s attitudes toward food and
eating behaviours.
Media Influence: In their expanding world, children come under the influence of the media.
Children want to try foods they see advertised on television. Fast-food establishments, with their
playgrounds and giveaways are also attractive to children. With more and more children having
access to the interned, food companies are finding new way to market their products to children.
Snacking: During middle childhood, children cannot consume large amounts of food at one
time and therefore need snacks to meet their nutrient needs. Many children prepare their own
breakfasts or after-school snacks.
Food Preference Development, Appetite, and Satiety: Researchers have described the
innate ability of young children to internally control their energy intake and their responsiveness
to energy density. The internal controls can be altered by external factors, such as child-feeding
practices. External factors such as the time of day, the presence of other people, and the
availability of good food begin to override the internal controls of hunger and satiety as children
get older. Children of parents who imposed authoritarian controls on their children’s eating were
less likely to be responsive to energy density. In other words, these children were not able to
listen to internal cues in energy regulation.
Body Image/Excessive Dieting: Parents who had difficulty controlling their own intakes
seemed to impose more restrictions on their children. The more the mother is concerned with
her own weight and with the risk of her daughter becoming overweight, the more likely she is to
employ restrictive child-feeding practices. Externl factors such as the time of day, the presence
of other people, and the availability of good food begin to override the internal controls of hunger
and satiety as children get older. Children of parents who imposed authoritarian controls on their
children’s eating were less likely to be responsive to energy density. In other words, these
children were not able to listen to internal cues in energy regulation.
Body Image/Excessive Dieting: Parents who had difficulty controlling their own intakes
seemed to impose more restrictions on their children. The more the mother is concerned with
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