Physical Activity & Nutrition for Children and Adolescents

Approaching 2020 Spring Break, many parents were looking forward to a week with their children being home from school. That week has turned into several, as many of us are working from home and schools have transitioned to online learning in attempts to prevent the spread of COVID-19. This surprise transition has its’ benefits and challenges, with one benefit being more time with our immediate families. This is a good opportunity for parents to implement more positive influence, while their children and teens are stuck with them! Parents, teachers and everyone else can become strong influences on children and young adults, including the impressions we provide from a distance, through avenues like social media. Even if you don’t interact much with children and young adults, they are watching you; hence the reason we should aim to be good examples in all areas of life, not just for ourselves but for the future generation. In regards to physical activity and nutrition among children and adolescents, parents and adult role models have a huge influence on their success. While many parents are working from home and many public school students are forced to home school, I encourage parents, caregivers and those of us who influence them, to demonstrate a healthy lifestyle. Even if children do not follow suit, remember they are watching and will think back to those work-out breaks you took, saying they help you focus, feel better and prevent health risks.

 

Maybe knowing the power of your influence, as a healthy role model, will become your motivation to live a healthy lifestyle. This is why we need more good role models:

 

Increased prevalence of obesity in the United States poses major health concerns, including its’ correlation with the top cause of death in the nation, heart disease. Prevention is easier than reversing obesity, hence the reason the American Heart Association recommends starting with children. Behaviors, preferences and food habits established in childhood will have an impact when they become adults, beginning with toddlers, ages 1 to 3 years old. Even in children and young adults, obesity is associated with high cholesterol, increased concentrations of liver enzymes, high blood pressure and abnormal glucose tolerance, including Type II diabetes; and one in four teens have elevated cholesterol.

 

Step one in prevention begins with parents and caregivers of children and young adults. It is very difficult to implement healthy behaviors when not leading by example. With that said, parents and caregivers who struggle with control over their own diets tend to implement more restriction with children, which can be problematic. Restrictive eating is more likely among daughters whose mothers are concerned with them becoming overweight or being overweight themselves. Restrictive eating or dieting actually encourages children to desire the foods/drinks they are restricted from consuming, which increases their risk for becoming obese! So, goals should include encouraging a child’s internal hunger and satiety cues by giving child-size portions, encouraging a variety of foods and avoiding restrictive behaviors, like giving food as a reward for being good, forbidding specific foods or considering foods bad. Culture plays a huge role in caregiver influence as well. In some cultures, slim children are considered unhealthy and sharing food is a way to show one’s love. To help with such cultural differences, a child’s growth should be monitored based on CDC Growth Charts to know when children/adolescents are not getting adequate nutrition or becoming overweight. Encouraging healthy dietary habits include the following:

 

  • Provide adequate toddler-size portions, using the Rule of Thumb technique: 1 Tbsp of food per year

    of age

  • Let toddlers control the amount of food they eat, based on their hunger

  • Among toddlers, it typically takes 8 to 10 introductions to a new food before they accepts it, so offer it when they’re hungry along with familiar food they like, and remember they like to imitate, so it helps when you eat it too.

  • Do not require children to finish their food before leaving the table

  • Eat together as a family, sitting down without a TV/cell phones

  • Do not use food as a reward

  • Do not restrict foods; instead, simply keep healthier foods accessible and foods needed to be limited, less accessible most of the time

  • Pay attention to CDC Growth Charts, which account for normal growth spurts and BMI Rebound (the normal increase in BMI around 5 to 7 years old)

 

What To Do When Children are Overweight or Obese

 

Treatment for overweight and obese children and adolescence is determined based on their BMI for age percentile and methods that will not slow their linear growth or prompt eating disorders. Treatment occurs in the following stages, based on BMI for age, as indicated by CDC Growth Charts:

 

  • For children with a BMI for age between the 85th and 94th percentiles, the goal is to maintain or slow the rate of weight gain until the child simply grows into their weight and drops below the 85th percentile

  • For children with a BMI for age between the 95th and 98th percentile, the goals is weight maintenance or gradual weight loss, not exceeding more than one pound of weight loss per week, until below the 85th percentile

  • For children with a BMI in the 99th percentile or above, weight loss should not exceed two pounds per week until they are below the 85th percentile.

 

Unlike adults, children and young adults have the advantage of growth, but it is also a reason for caution in regards to weight loss. During growth, adequate nutrition is critical for healthy development, including brain, reproductive, height, bone and muscle development, hence the reason recommended weight loss for overweight and obese children must be very conservative, while also being cautious not to implement behaviors that could promote disordered eating. Avoid drastic measures, keeping in mind that the primary goal is to establish healthy lifestyle habits and behaviors that will last a lifetime.

 

Physical Activity Guidelines for Children and Adolescence

 

Lack of physical activity is a huge contributing factor to the prevalence of obesity, so physical activity is a primary treatment and prevention for becoming overweight or obese. Increasing a child’s or adolescents’ physical activity may be all they need to acquire a healthy weight. Unfortunately, physical activity tends to decrease with age, hence the reason organized sports, ensuring they are desired and not forced, are advocated. Preschool-age children, 3 to 5 years old, should be physically active throughout the day and children and adolescents, ages 6 through 17 years old, need at least 60 minutes of physical activity, of moderate to vigorous intensity, per day, as adults do. Most of the 60 minutes needs to be moderate or vigorous-intensity aerobic exercise, being that which gets the heart rate up but can be prolonged (sustained or repeated intervals of increased heart rate), and part of it should include strength training, at least three days per week, for bone and muscle health and growth.

 

Nutrition for Children and Adolescents

 

Some recent concerns in childhood nutrition include the following:

  • Energy Balance

  • Excessive Dietary Fat

  • Excessive Saturated Fat

  • Excessive Sugar

  • Excessive Sodium

  • Inadequate Calcium

  • Inadequate Potassium

  • Inadequate Vitamin D

  • Inadequate Fiber

  • Inadequate Fish

  • Inadequate Fruits

  • Inadequate Whole Grains

  • Inadequate Vegetables

  • Inadequate Dairy

 

To simply put it, children need more physical activity to match their caloric intake, and energy-dense and empty-calorie foods need to be replaced with nutrient-dense foods.

 

Energy-dense foods: foods with high-caloric values in comparison to their weight

- Candy Bars, Full-fat Dairy, Chips

 

Empty-calorie foods: foods with excess calories in comparison to their amount of nutrients

- Soft Drinks, Sherbet, Hard Candy, Alcohol

 

Nutrient-dense foods: foods with a lot of nutrients in comparison to their caloric value

- Vegetables, Nonfat Dairy, Lean Meats, Dried Beans, Fruits

 

Fat is calorie-dense, but the right sources are needed. Fat should include 25 to 35 percent of their daily calories, with a strong emphasis on consuming adequate essential fatty acids:

      

- All Children 4-8 years old: 10 grams/day of Linoleic Acid (Omega-6) & 0.9 grams/day of Alpha-Linolenic Acid (Omega-3)

 

- Boys 9 to 13 years old: 12 grams/day of Linoleic Acid (Omega-6) & 1.2 grams/day of Alpha-Linolenic Acid (Omega-3)

 

- Girls 9-13 years old: 10 grams/day of Linoleic Acid (Omega-6) & 1 gram/day of Alpha-Linolenic Acid (Omega-3)

 

Omega-6 fatty acids are found in seeds, nuts, whole grains and vegetable oils. Omega-3 fatty acids are found in fish, so at least two servings of fish per week is recommended.

 

For specific amounts of food and recommended sources for age, refer to:

 

https://www.choosemyplate.gov/resources/MyPlatePlan 

 

Lead By Example

 

As mentioned before, it is important not to influence youth with restrictive habits. We walk a tight rope in dealing with youth, because influence is so powerful in their lives. Think positivity over restriction in regards to food and physical activity. I hope this information serves as encouragement, not only for parents and caregivers, but for everyone. We are currently relying heavily on the robust amount of information available through marketing, social media, Internet and other technologies, during the needed social distancing to limit the spread of COVID-19; so I hope to encourage everyone to share positive information and truth, knowing our youth our watching.  

 

References

Brown, J. E. (2017). Nutrition Through the Lifecycle. Boston, MA: Cengage Learning.

Ogata, B. N., & Hayes, D. (2014).  From the Academy: Position of the Academy of Nutrition and Dietetics: Nutrition Guidance for Healthy Children Ages 2 to 11 Years [PDF]. From the Academy: Position of the Academy of Nutrition and Dietetics: Nutrition Guidance for Healthy Children Ages 2 to 11 Years [PDF]. - Alternative Formats  Journal of the Academy of Nutrition and Dietetics, 114(8): 1257-1276. 

https://www.niddk.nih.gov/health-information/weight-management/helping-your-child-who-is-overweight#concern

https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf

https://www.cdc.gov/healthequity/lcod/men/2017/all-races-origins/index.htm

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