Correlations between nutrition and child growth

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.

+

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 (8^th ed.). Boston: Allyn and Bacon.

Berk, L. E. (2012). Infants and children: prenatal through middle childhood (7^th ed.). Boston: Allyn and Bacon.

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 (7^th ed.). New York, NY: McGraw-Hill.

Fitzsimons, D., Dwyer, J. T., Palmer, C., & Boyd, L. D. (1998). Nutrition and oral health guidelines for pregnant women, infants, and children. American Dietetic Association.Journal of the American Dietetic Association, 98(2), 182-6, 189; quiz 187-8. Retrieved from http://search.proquest.com/docview/218396541?accountid=8289

Johnson, S. L. (2002). Children's food acceptance patterns: The interface of ontogeny and nutrition needs. Nutrition Reviews, 60(5), S91-4. Retrieved from http://search.proquest.com/docview/212311822?accountid=8289

Parke, R. D., & Gauvain, M. (2009). Child psychology: a contemporary viewpoint (7th ed.). United States: McGraw-Hill.