Children must be taught healthy eating habits early
Fruits and vegetables should be the core of healthy diet, says food scientist
The proliferation of fast-food chains has made tasty and convenient meals more easily available than ever. The fast-food industry is obviously aimed at the younger crowd, with colorful and attractive mascots boosting their marketing and promotional campaigns. In fact, many establishments have created products that appeal specifically to children: packages containing smaller servings plus a toy.
Unfortunately, the nutritional impact of current eating behavior leaves much to be desired, said nutrition expert Paula Ziegler, PhD, principal scientist at Gerber Products Company based in Fremont, Michigan, usa. While children are eating more, they are not necessarily getting any healthier.
Speaking in a symposium on The Importance of Establishing Healthy Eating Habits in the First Two Years of Life during the 2004 annual convention of the Philippine Pediatric Society, Ziegler elaborated on the prevalence of malnutrition, the growing problem of overweight and obesity, and the long-term benefits of starting good eating habits early in life.
Wrong eating habits
Unknown to many, malnutrition starts as early as the first year of life. Using data from the Food and Nutrition Research Institute (FNRI), Ziegler, pointed to a disturbing percentage of Filipino children below three years of age who either weigh low or stand short for their age. But equally disturbing, she noted, is that one percent of infants are overweight--and this figure goes up to 1.3 percent in the two-year-olds bracket.
Comparative 1989 and 2001 data also show that while the prevalence of underweight among children under five has gone down from 34.5 to 30.6 percent, the prevalence of overweight has nearly doubled from 0.6 to one percent.
Ziegler, who is also an adjunct professor at the College of St. Elizabeth in Morristown, New Jersey, attributed the large number of overweight children to wrong eating habits acquired early in life. Drawing upon the Gerber Feeding Infants and Toddlers Study (fits, Journal of the American Dietetic Association, Jan. 2004), she showed that infants and toddlers today are consuming lesser fruits and vegetables and more "inappropriate" high-calorie foods.
The survey found that, in the nine to 11 months age bracket, for instance, only 33 percent eat vegetables at least once a day. The ratio drops to nine percent among children ages 19 to 24 months (Figure 1). Instead, vegetables are replaced by low-nutrient, high-calorie foods (Figure 2). "That's pretty alarming," said Ziegler, noting that the most common "vegetable" in the diet of children today is fried potatoes, that is, French fries.
Because of this, children are starting to be deprived of essential nutrients, like iron and vitamins, while adding more fats and pounds to their bodies.
Ziegler said this is a sad development because the growing body of scientific evidence suggests that fruits and vegetables should be "the core of a healthy diet," not only to have good nutrition but also to reduce the risks of obesity, cardiovascular diseases, and cancer.
Nutritional programming
Ziegler observed that older children and even adults tend to choose what they eat based on what they remember liking during their earlier years.
Fruit and vegetable intake in childhood is the strongest predictor of fruit and vegetable intake in adulthood--that is, if they like the taste and have been in the habit of eating them since childhood, said Ziegler, citing studies by Krebs-Smith.
Thus, problematic eating habits in later life stem largely from parents feeding their children the wrong kind of food during their first year. "The key thing is that [children learn] many of their food preferences early--below age two," asserted Ziegler. It is therefore crucial that children be fed correctly from the start--even beginning in the womb. Ziegler said a baby's exposure to different food flavors begins with what the mother eats during pregnancy.
Once the baby is born, another good way to promote nutrition and develop the baby's tastes is regular breast-feeding. Ziegler noted that breast-fed infants "tend to like more or accept more new foods." Babies also tend to like and eat more cereal if it is mixed with breast milk instead of water or formula.
Babies should also be given foods that vary in taste and texture as early as possible. Ziegler cited studies showing that infants given a variety of vegetables tend to accept more novel foods as they are introduced later.
Children should be given the chance to try as many foods as possible--with emphasis on fruits and vegetables rather than candy, pizza, and soft drinks--during their growing years so that they develop a taste for the healthier food choices available.
The virtue of patience
Ziegler pointed out that many babies are in fact not even allowed to fully develop a taste for healthy food. Many mothers, when introducing solid food to infants, usually try something new two or three times and then give up, concluding that the baby "does not like it." Consequently, "junk" food is given preference because the child seems to enjoy it more.
However, said Ziegler, this should not be the case. Quoting studies, Ziegler said that it could take up to 10 exposures before a baby fully accepts a new food. Thus, mothers should persist even when their babies seem to dislike what they are eating, especially if the food is good for them. Also, mothers should not be quick to interpret a baby's messiness and "making faces" while eating as a sign of dislike. Quite often, pointed out Ziegler, they might just be exploring and enjoying the novel taste. After 10 or more exposures, many babies eventually get to "like" what they "disliked" initially.
Five a day
A simple and effective way to get parents to feed their infants and toddlers correctly is to institute a "five a day" mindset. In this approach, parents should be encouraged to feed children at least five servings of fruits and vegetables a day, which is often sufficient to meet their nutritional requirements.
Another approach would be to give cereals and ready-to-eat baby food such as Gerber in a nutritionally equivalent amount (two-and-a-half jars are equal to five servings). Ziegler said this feeding formula would also help meet the child's requirements for vitamins and iron, among other minerals, which are crucial during the period of rapid growth. "We know that the baby's iron stores will be depleted by four to six months [of age] and breast milk does not provide enough iron to meet the infant's needs," she stressed.
Giving babies cereals and baby food in jars rich in iron will help overcome iron-deficiency anemia, which Ziegler noted affects 56 percent of Filipino infants below one year of age based on FNRI data. A four-ounce daily serving of carrots (Gerber jars) will also meet requirements for vitamin A, she added, especially for 35 percent of Filipino infants who have vitamin-A deficiency.
Summing up, Ziegler said the challenge to pediatricians is in helping educate mothers about proper nutrition and the development of good eating habits.
C.R.Y. Cruz, MD
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