UNIT-3

NUTRITION FOR PRESCHOOLERS

CONTENT
• Growth and development.
• RDA
• Nutritional requirement during preschool
• Nutritional deficiency-PEM
• Effects of undernutrition
• Factors to be considered while planning the menu.
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 .
Growth and development
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.

Continuition...
• 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.
RDA for Preschoolers
• Recommended Daily 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

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

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

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:
• 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

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 .
PEM
• 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 .
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• 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
• Marasmic Kwashiorkor
• Marasmus
• Nutritional dwarfing
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:

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.
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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.
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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.
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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.
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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.
THANK YOU