A paper I wrote for a psychology class:
Correlations
Between Nutrition and Child Growth:
A
Guide for Parents and Caregivers
Annika
Boudwin
American
Public University
Abstract
Nutrition and genetics both
contribute to a child’s physical and intellectual growth. However, whereas genetics cannot be
influenced after conception, parents and caregivers can affect a child’s
nutrition intake and encourage healthy eating habits in order to help a child
achieve proper growth. Proper nutrition
and vitamins can deter malnutrition and obesity. Parents should maintain
cheerful attitudes at mealtime and offer a variety of healthy food while
encouraging their children to learn self-regulation rather than attempting to
control what the child eats.
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Correlations Between Nutrition and Child
Growth
Parents proudly show off their children
to friends, often remarking on how well their children are growing. However, when children do not seem to be
growing well, it is easy to question one’s own ability as a parent, and whether
the lack of growth is based on genetics or inadequate nutrition. The child’s diet may be questioned by the
doctor, but regardless of whether diet or genes are the underlying factor, it
is important that all children partake of a healthy diet because nutrition can
affect physical growth and cognitive ability. There are several ways in which
parents can encourage healthy eating.
First of all, a child’s growth is
generally expressed in an up-over-down, in-over-out growth pattern. The brain takes priority over the growth of
the limbs, and growth of the organs and torso take priority over growth in the
hands and feet (Parke & Gauvain, 2009). This is why small children will have very
large heads and large torsos coupled with relatively small arms and legs. In addition, growth is generally determined by
the bones which have epiphyses, or “growth centers,” one on each end of the
long bones in a child’s body. These
epiphyses grow cartilage that, over time, is fused into the bone. Once the cartilage of those epiphyses has
disappeared, growth is complete. Skeletal
age is determined by x-raying the epiphyses (Berk, 2012, p. 163). Sometimes children do not grow for a period
of time and then they experience rapid growth over a short period of time,
before which they tend to be hungrier and more tired (Berk, 2012).
The first concern in providing
proper nutrition to a child is whether to use formula or to breastfeed. Generally speaking, breastfeeding is
preferable over formula, particularly in developing countries. “The World Health Organization recommends
breastfeeding until 2 years, with solid foods added at 6 months” (Berk, 2012,
p. 175). Many babies are fed formula
diluted with milk or water that is often unsanitary. The lives of over a million infants could be
saved if WHO’s recommendation was followed. Breastmilk provides proper fat and protein,
contains a baby’s necessary nutrients, immunizes the baby from many diseases,
helps prevent tooth decay, and is more digestible than formula (Berk, 2012, p.
175). Even the “U.S. Department of
Health and Human Services advises exclusive breastfeeding for the first 6
months and inclusion of breast milk in the baby’s diet until at least 1 year”
(Berk, 2012, p. 176). Children who were
breastfed are also less likely to be overweight and more likely to be leaner
when they get older (Berk, 2012). Nutrition is especially important during the
first two years because their rate of growth in the brain and the body is very
rapid. “Pound for pound, an infant’s
energy needs are at least twice those of an adult.” A quarter of the calories consumed are used
for growth and extra calories are needed to ensure proper organ development
(Berk, 2012, p. 174).
As the child gets older and starts
growing teeth, it is important to maintain proper dental hygiene even before
permanent teeth come in. One of the
reasons is that poor dental hygiene can cause tooth or mouth pain, which in
turn can result in difficulty eating and “failure to thrive in young children” (Fitzsimons,
Dwyer, Palmer & Boyd, 1998, p. 185). Between-meal snacks that are more likely to
cause tooth decay include frequent sipping of “juice, milk, soda, or any
sweetened liquid” (Fitzsimons et al., 1998, p. 186). In addition, “baby teeth can affect the health
of permanent teeth,” increasing the importance of regular brushing and
moderating sugary snacks (Berk, 2012, p. 290).
Growth rates and charts are frequently
used to give parents an idea of how well their child is growing. Generally speaking, babies are 50 percent
taller and three times as heavy at one year as they were at birth. At two years old, they are 75 percent taller
and four times as heavy as at birth. Children
grow two to three inches taller and gain about five pounds each year on average
(Berk, 2012). There are two extremes
that can negatively influence proper growth: malnutrition and obesity.
Malnutrition, especially coupled with
disease, can cause severe and long-lasting consequences. “Poor diet suppresses the body’s immune
system, making children far more susceptible to disease” (Berk, 2012, p. 301). However, disease also makes a detrimental
contribution to physical and cognitive development. It can prevent the body from absorbing food
and inhibits appetite. Diseases like
diarrhea prevent proper growth and cognitive development and diarrhea alone kills
two million children every year. However,
most of the detrimental effects caused by diarrhea, including death, can be
prevented by using a cheap solution containing glucose, salt, and water to
replace bodily fluids. However, if
malnutrition is persistent, it can result in stunted growth and hinder a child’s
ability to cope with stress. Malnutrition can also contribute to poor motor
skills and inattention. Additionally,
early malnutrition can result in later obesity as the body has learned to slow
its metabolism rate to accommodate poor nutrition (Berk, 2012). Thankfully,
however, children can exhibit catch-up growth when malnutrition is not extreme.
Whether from birth or due to lack of proper nutrition, children that are small
for their size can catch up to their normal growth curve once proper nutrition
is again provided. Nevertheless, timing is important and nutritional deficits
before birth or early in a young child’s life are more difficult to correct
than nutritional deficits when the child is older (Parke & Gauvain, 2009).
Compared to malnutrition, obesity does
not seem to directly affect a child’s growth in height, but it certainly
affects a child’s weight and consequently can cause social and emotional
problems. Obesity can also lead to
diabetes, as well as kidney failure and circulatory issues (Berk, 2012). A study of families with infants and toddlers
found that “infants consumed 20 percent and toddlers 30 percent more calories
than they needed. At the same time,
one-third ate no fruits or vegetables” (Berk, 2012, p. 176). “Overweight children are more likely to eat
larger quantities of high-calorie sugary and fatty foods,” which may be a
result of their parents eating similar foods regularly (Berk, 2012, p. 418). In addition, some parents may use food to
comfort a child whenever the child is distressed.
However, it may seem counterintuitive,
but strictly regulating how much and how often a child eats, while stressing
about weight gain can also contribute to obesity. A strict schedule and parental pressure
inhibits a child’s ability to learn how to recognize hunger cues and
self-regulate eating. Children at
greater risk of obesity are also more likely to eat quickly and spend less time
chewing. Obesity is also associated with
children who do not get enough sleep, possibly because fatigue contributes to
lower activity or because children have more time to eat. In addition, children who watch a lot of TV
are at greater risk as well, because they also spend less time being active and
they are exposed frequently to commercials featuring unhealthy foods (Berk,
2012). To help prevent obesity, parents
can reduce time in front of the TV, encourage regular physical activity,
increase accessibility to fruits and vegetables, moderate fat intake and help
children be aware of what they are consuming. However, obesity could be a genetic issue as
well as a nutritional issue, so it is better not to obsess about a child’s
weight (Dacey, Travers & Fiore, 2009, p. 228).
Unfortunately, obesity is often a family
disorder; overweight children tend to have overweight parents. However, parents are often unwilling to either
recognize that their children have a weight problem or to change their own
eating and exercise habits in order to help their children. On the other hand, children are more likely
than adults to permanently recover from obesity, so early intervention is best. One way to encourage activity is to reward a
child with something like a ball-game ticket or zoo trip, where the reward also
involves the outdoors instead of sweets (Berk, 2012).
Vitamins help to ensure that essential
nutrients are provided to the body. Some
crucial vitamins include iron, calcium, zinc, vitamin A and vitamin C. Iron helps prevent anemia, calcium ensures
proper growth of the bones and teeth, zinc strengthens the immune system and
brain, vitamin A strengthens the eyes, skin and several internal organs and
vitamin C helps absorb iron and facilitates healing. In addition, these vitamins “are the most
common dietary deficiencies of the preschool years” (Berk, 2012, p. 300). Lack of sufficient iron and folate can
contribute to poorer mental ability (Berk, 2012). In addition, there is evidence that a lack of
iron, zinc and magnesium contribute to detrimental behavior and cognitive
development in children (Briley & Roberts-Gray, 1990).
Some foods that are particularly healthy
snacks for children include meat, fruit, vegetables, milk, legumes, bread, eggs
and peanut butter. Furthermore, children
who do not drink milk are shorter and have less bone density than children who
do drink milk. Some recommendations for helping children eat healthy involve
having predictable meal times and multiple snacks throughout the day, serving
the child small portions and allowing the child to have seconds, offering a
variety of foods, and introducing new, healthy food frequently and early in a
meal while maintaining patience if the child rejects it. It is also helpful to
have pleasant mealtime conversations that include the child, avoid conflict
during mealtime, and not restrict access to particular foods. Children may simply need easier access to
healthy food in order to be more healthy. Unfortunately, in some homes, snacks
like chips are easier to find and eat than vegetables, cheese, fruit or peanut
butter (Berk, 2012). More possible snack
alternatives could include cereal that isn’t very sweet, cheese, crackers, some
cookies, fruit juice, low-fat chocolate milk, peanut butter and jelly
sandwiches, smoothies and fruit shakes made with skim milk (Dacey et al., 2009).
However, the American Dietetic
Association reminds us that children have more taste buds on their tongues and
cheeks than adults and so children do not need the extra salt or sugar that
adults often want to use to flavor food (Briley & Roberts-Gray, 1999).
While eating is pleasurable and a
central part of any person’s life, it should not be used to guide behavior
whether as a reward or as a punishment (Briley & Roberts-Gray, 1999). Children learn to prefer foods that are used a
reward, while the foods they are rewarded for eating become more disliked (Johnson, 2002). In fact, one study where children initially
liked both apple and peach bars showed that the children started preferring the
apple-bar cookies over the peach-bar cookies as the apple-bar cookies became
less accessible. Once the apple-bar
cookies were accessible again, children ate more of them than they had earlier
(Berk, 2012).
Parents should avoid confrontation where
children’s eating habits are concerned.
Johnson (2002) asserts that “feeding practices that are power-assertive and focused on
external adult control have been linked to maladaptive effects on children's
self-regulation of energy intake. Feeding environments in which children have
little social contact with and encouragement from their care providers produce
equally maladaptive outcomes. Caregiver
strategies that center on internal signals of hunger and satiety engender
greater sensitivity to energy density of the diet and better self-regulation
skills” (p. S93). In addition, children
have internal cues to help encourage them to consume more calories when needed
(Johnson, 2002).
During
the second half of a child’s second year, children generally start exhibiting
distaste for any new food that is introduced. As a result, parental-child relationships
often experience rising tension as parents attempt to pressure the child into
eating the new food. However, it is
better for parents to introduce the new food frequently, without using heavy
pressure to make the child eat it. Children
will generally eat new foods over time, after repeated exposure to the food (Johnson,
2002). In addition, child caregivers are encouraged to offer, but not force,
children to taste foods that are offered to them (Briley
& Roberts-Gray, 1999).
In spite of all this, it is essential
for parents to understand that much of a child’s growth is determined by
genetic influences rather than nutrition. In fact, research suggests that
two-thirds of a child’s growth is determined by genes rather than the environment.
For example, an adopted child is more likely to show growth resembling his or
her biological parents instead of his or her adopted parents. Identical twins
reared apart are also likely to resemble each other instead of their adoptive
families (Parke & Gauvain, 2009).
Discussion
Genetics play more of a role than the
environment in determining a child’s growth (Parke & Gauvain, 2009). However, it is the responsibility of
caregivers and parents to ensure that genetics is not hindered by a lack of
essential nutrients. Children require
calories and essential nutrients in order to achieve ideal growth and mental
capacities.
Infants should be breastfed when
feasible, particularly in developing countries.
Frequent feedings are necessary because the baby’s body processes breast
milk quickly (Berk, 2012). As they get
older, children should be offered a variety of healthy foods from the primary
food groups frequently throughout the day.
Young children may suddenly start avoiding new foods, but that does not
mean that parents should not keep offering the food to the child. The child may opt not to eat the food
offered, but caregivers and parents should avoid pressuring the child and
instead offer the same food regularly at the beginning of meals. Mealtimes should be coordinated between
family members and be pleasant and unhurried, allowing the child to eat
slowly. Making mealtime an enjoyable,
social event encourages the child to not eat quickly and to not view family
meals as unpleasant. However, when parents or other caregivers use meals to
pressure a child to eat particular foods, then the child is more likely to
develop an aversion to the food and to dislike mealtime in general. As the child is offered a variety of healthy
food to eat, he or she should be served small portions and given control over
how much and which food to eat, because a child that is able to self-regulate
calories generally has a body that knows best what it needs (Berk, 2012; Briley
& Roberts-Gray, 1999; Johnson, 2012).
Calcium in milk is important to proper
bone growth, which in turn affects a child’s height. Teeth, whether baby teeth or adult teeth,
should be properly cared for to avoid oral pain that can inhibit healthy eating
(Berk, 2012; Fitzsimons et al., 1998). Vitamin
supplements are helpful in ensuring a child receives adequate nutrition. Unhealthy foods should not be used as rewards
and given greater desirability over healthier foods (Fitzsimons et al., 1998; Johnson, 2002). Healthy foods should be just as accessible as
unhealthy snacks, possibly cut up and placed in small serving-size-portioned
containers for easier retrieval and portability.
If a child does experience malnutrition,
it is possible for the child to catch up to genetically-determined growth once
proper nutrition is again available. In
cases of severe malnutrition, such as persistent diarrhea, caregivers can use medicine
to provide a child with crucial fluids needed to replace the fluid being
lost. If malnutrition persists, the
child may experience growth stunts or impaired intellectual capacity. Even mild
malnutrition can cause behavioral or cognitive problems (Berk, 2012).
On the flip side, parents and caregivers
should be cautious of obesity. Obesity
can be caused by genetics, but it is also advisable for parents to watch their
own diet because children generally follow the eating and exercise habits of
their parents. Using the same
recommendations already given for healthy eating can help with obesity.
However, given that obesity can simply be a genetic issue, parents and
caregivers should avoid focusing on the obesity itself (Berk, 2012; Dacey et
al., 2009). Parents and caregivers should follow the same guidelines whether
their children are overweight or not: encourage activity, offer a variety of
healthy foods, make mealtimes a pleasant, social activity and do not obsess
about the child’s weight or overregulate what the child eats. Parents and caregivers should set an example
of activity and healthy eating.
Even though it is clear that children
should eat healthy foods to achieve optimal growth and health, it is unwise for
caregivers to strictly regulate when and how much the child eats. Offer healthy foods in a pleasant atmosphere
and keep offering the same foods even when the child does not eat them (Berk,
2012, Briley & Roberts-Gray, 1999; Johnson, 2012). Be an example to the
child in eating healthy and seek out opportunities in which to serve healthy
food in a variety of ways, given that “variety is the spice of life,” and few
people like to eat the same thing every day.
Let the child understand that his or her input on food is valued and
help the child learn self-regulation rather than simply obeying commands. Finally, one of the best ways a parent or
caregiver can help a child grow properly is to be a role model in healthy
habits.
References
Berk,
L. E. (2009). Child development (8th
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Berk,
L. E. (2012). Infants and children:
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Briley,
M. E., & Roberts-Gray, C. (1999). Position of the american dietetic
association: Nutrition standards for child-care programs. American Dietetic
Association.Journal of the American Dietetic Association, 99(8), 981-8.
Retrieved from http://search.proquest.com/docview/218452080?accountid=8289
Dacey,
J. S., Travers, J. F., & Fiore, L. B. (2009). Human development across the lifespan (7th ed.). New
York, NY: McGraw-Hill.
Fitzsimons,
D., Dwyer, J. T., Palmer, C., & Boyd, L. D. (1998). Nutrition and oral
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S. L. (2002). Children's food acceptance patterns: The interface of ontogeny
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Parke, R. D., & Gauvain, M.
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