NUTRITION FOR PRESCHOOLERS

GROWTH AND DEVELOPMENT :

 The term growth denotes a net increases in the size of mass of tissues . The
process starts from the time of conception and continues till adulthood .
 Growth continues at a rapid rate in preschool years, but is slower than growth
during infancy.
 During the second year , the increase in height is about 12-15cm and weight gain
about 2.5kg .
 Growth rate varies for each individual child.
 Between the ages of 2-5 , children on a average , gain about 2kg and about 7-
10cm per year .
BODY COMPOSITION:
 By the time, the child reaches 2years of age , much of the baby fat is lost , the
muscles especially in the back, buttocks, and legs are strengthened and the leg
bones lengthen.
 Bone mass and density will increase.
 As the child continues to grow, protein deposition continues and other tissues
including connective tissues, teeth, body fat, skin and the nervous system,
 The increase in the length of bones and strengthening of muscles is obvious in the
increase in height and strength of muscles.
PHYSICAL AND MOTOR DEVELOPMENT :
 Preschoolers strive for independence and gain competence in various activities .
 They should be encouraged to participate in active play ; as it provides an
opportunity to develop gross motor co-ordination .
 By 2 years of age, most children can move up the stairs one at a time, draw
simple strokes with a pencil, and kick a ball.
 By age five they can their shoe laces,dress and undress themselves,write some
lowercase and capital letters, and can pour milk.
LANGUAGE DEVELOPMENT:
 Preschool is an important time for language development.
 A 2 year old can speak at least 50 words and the child may know thousands of
words by the time he/she is five years old .
 Preschoolers are able to carry on conversations and tell stories .
 A 2 year old can begin to communicate with yes/no, or equivalent words about
what they want/do not want to eat.
 They able to carry on conversations and tell stories.
 3 years- Preschooler can verbally request for certain foods.
 Start learning from pears and media .
COGNITIVE DEVELOPMENT:
Preschool years mark great improvements in the ability to think and reason .
 It is around this time that children learn their letters, counting and colour.
They are usually inquisitive, asking ‘why’ for everything . The kitchen provides
opportunities for experiments, crafts, and participation in food preparation .
 They are comfortable with familiar, but are willing to try new challenges.
 Food fads are common at this time. Preschoolers may complain or whine about
what is served , refuse certain foods, especially vegetables, pulses and meats, and
push foods around the plate.
 This is known as ‘picky eating’.
But the good thing is that pick eating is temporary .Although variety may be limited
while the fad persists.
EMOTIONAL AND SOCIAL DEVELOPMENT :
 Between the ages of 2 and 5, preschoolers gradually learn how to manage their
feelings.
 This is the time when peers become increasingly important . Most preschool child
like sharing foods with friends and caregivers .Each child grows and gains skills
at her/his own place. It is common for a child to be ahead in one area , such as
language , but a little behind in another.
RECOMMENDED DIETARY ALLOWANCES:

NUTRIENTS PRESCHOOL
( 1 to 6 years )
Energy 1060
Protein 16.7
Fat 27
Vitamin A 3200
Vitamin C 40
Iron 09
calcium 600
NUTRITIONAL REQUIREMENT DURING PRESCHOOL:
ENERGY:
The RDA suggested by ICMR reduced from the earlier recommendations , the energy
requirement of children aged 1-2 years by 7 percent to fit with energy requirement of
infants .Energy is required for growth and activity . Insufficient food will not only
result in under nutrition in terms of inadequate weight gain but will also hinder
growth.
 Up to 10 years of age, there is no difference in sex for RDA.
 Due to improper weaning practice, the child may not meet calorie and protein
requirement leading to Protein-energy malnutrition. Insufficient calorie intake can
lead to protein deficiency.
PROTEIN:
 The increase in the muscle mass that must accompany bone growth requires
positive nitrogen balance that is met by protein intake of 1.3 g/kg body weight.
 The increase in total body size, necessitates a larger vascular system to transport
nutrients to the tissues and waste all products away from the tissues. Thus there is
an increase in demand for nutrients needed in blood formation like protein, iron,
folacin, and pyridoxine. Bone growth also creates a need for protein.
FAT:
Fat requirement up to 2 years of age can be between 30-40 percent of the total
energy,and at 15-30 percent of the total energy intake . This translates into visible fat
intake of 27g/d for 1-3 year old children and 25g/d for 4-6 year children.
VITAMIN-A:
A requirement of children range between 300-400µg retinal / day. While considering
the RDA for preschool children, the ICMR reviewed studies showing that vitamin A
deficiency is common at intakes below 100µg/d. Therefore, the ICMR has
recommended 400µg/day of retinal equivalents, or 3200µg/day of β -carotene among
preschool children.
IRON:
During growth, 30 mg of iron is required and since the increase in body weight during
childhood is 2 kg/year on an average , the daily requirement of iron for growth will be
0.2mg. The physiological requirement for iron can vary for 1-2 years from 0.2-0.5
mg per kg of body weight per day.
CALCIUM:
 Calcium requirement of children is calculated on the basis of the amount of
calcium accretion in the body.
 Since all dietary calcium is not absorbed 600mg/day is prescribed though the
actual requirement may be less.
 The RDA for phosphorus is 600mg/day.
 Deficiency of calcium can affect the bones of growing children.
 Milk is the best source of calcium.Hence the diet of preschool child should
include1-2 glasses of milk per day.
ZINC:
Since zinc requirement and the RDA based on balance and factorial data closely
correspond to FAO recommendations .
PROTEIN-ENERGY MALNUTRITION
Protein energy malnutrition is defined as a range of pathological conditions arising
from coincidental lack of varying proportions of protein and calorie, occurring most
frequently in infants and young children and often associated with infections .
 The peak prevalence of kwashiorkor is seen in age group of 2-3 years and
marasmus in 1-2 years.
 In 1971, dis systematic diet survey found that Kwashiorkor and marasmus
children conses similar diets .
 The child reacts to the stress of PEM and secretes cortisol which mobilizes
protein from muscle .
 Marasmus is said to be well adapted to the stress of deficit in protein and calories,
Sometimes the child is not able to adapt to the stress of inadequate diet , infection
and separation from mother due to subsequent pregnancy .
 The prevalence rate of severe degree of PEM in our community is 3-5 percent
.For every 3 to 5 cases of severe PEM , we can detect 80-90 cases of mild to
moderate PEM and about 10 percent of well nourished children .
 Systematic study of the habitual diets of these children indicated that the
concentration of protein in their food diet was adequate , but they were suffering
from energy , a food inadequate since they were not eating enough of their
habitual diet.
For every 3to5 cases of severe PEM, we can detect 80-90 cases of mild to moderate
PEM and about 10 percent of well nourished children.
Symptoms of different types of PEM:
Kwashiorkor:
Oedema of the face and lower limbs , failure to thrive, anorexia, diarrhoea, apathy,
dermatitis, flaky paint appearance , sparse, soft, and thin hair , angular stomatitis,
cheilosis and anaemia.
Marasmic Kwashiorkor:
These children exhibit a mixture of some of the features of both marasmus and
Kwashiorkor .
Marasmus:
Failure to thrive means children are not able to gain weight . Irritability , fretfulness
and apathy are common among them .
Their weight is persistently below the third percentile for age or less than 80 percent
of ideal weight of age .
Nutritional dwarfing :
Some children adapt to prolonged insufficiency of food energy and protein by a
marked retardation of growth.
Weight and height are both reduced resembling children a year or more younger.
UNDERNUTRITION:
Causes of underweight:
a) Due to poverty.
b) Abrupt weaning.
c) Malnutrition can result in less enzyme synthesis.
d) Chronic infections like primary can result in anaemia.
Effects of under nutrition:
I) Due to poverty, mother is not able to provide sufficient food to the child resulting in
under nutrition.
II) The starchy gruel's made from local stable food to the child like rice, wheat, bajra,
ragi, jowar, or maize would result in “Dietary bulk with a low calorie density”. Hence
the child may not be able to meet calorie requirement.
III) Abrupt weaning, Late weaning ignorance of importance of weaning can lead to
under nutrition.
IV) Malnutrition can result in less enzyme synthesis and less appetite leading to less
consumption of food .
V) Chronic infections like primary complex may result in anorexia.
VI) Infestations like ascariasis particularly giardiasis may lead to anorexia.
FACTORS TO BE CONSIDERED WHILE PLANNING THE MENU FOR
PRESCHOOLERS:
Preschoolers have two common preferences .First, they have a preference for routine
in daily life .Most children need some structure and routine to their day.Generally
they prefer meals and snacks at regular times, as governed by the family’s lifestyle.
I) The diet should be adequate in quantity and quality of different nutrients.
II) The preschool child should have two small servings of protein rich foods like eggs,
and other non vegetarian foods, pulses, paneer, or cheese.
III) When the child is about 12 months old, finger foods such as carrots can be given.
IV) Establish routines where the children sit down with their whole family and eat .
Avoid watching television during meal times.
V) The diet should include variety of of foods . The child should have access to items
from all food groups on a regular basis.
VI) Keep a snack box candy, containing healthy snacks foods such as pieces of fruits,
vegetables or small sandwiches.
VII) Do not give the child two large a serving.
VIII) Foods should be slightly seasoned so that they taste better and the child takes it
well.
IX) Regularity of meal time is essential .
X) Different cooking methods and new attractive combinations encourages the child
to eat more.
XI) Foods like tea and coffee should be restricted as they overstimulate the system .
XII) Inclusion of curd everyday in the diet can decrease the incidence of diarrhoea
and course of cold.
XIII) Food can be attractively served by using natural colour , or cut out in different
shapes to make it interesting for children.