The most important thing you can tell the parents or guardians of your pediatric patients in regard to the nutritional status of children is to build a positive relationship with healthy food
If you have pediatric patients, you’ve probably heard the same complaint from parents, over and over again, about how hard it is to get their children to eat a balanced diet. A new study on the nutritional status of children is showing a widespread problem across the U.S.
If you are also a parent, you understand this frustration at an even more personal level. No matter how many times you try, getting your kids to eat even fresh vegetables can be a battle. If this is true, neither you, nor the parents of your pediatric children, are alone. A new study, based on data from the National Health and Nutrition Examination Survey (NHANES), shows that American children, some as young as 1, have inadequate intake levels of certain vital nutrients, including calcium, DHA, vitamin D, and iron. Which nutrients are children lacking? How important are they? What strategies can you recommend that parents use to make sure their children are getting adequate amounts of these nutrients? Read further to find out more about the study details, as well as why its results directly affect not only your pediatric patients, but even your own family.
The nutritional status of children: study data
The 2021 article from the journal Nutrients used data from the National Health and Nutrition Examination Survey (NHANES), an annual survey conducted by the National Center for Health Statistics at the Centers for Disease Control & Prevention (CDC) to assess the nutritional status and health of US children and adults. For this study, the researchers examined the survey responses from 9,848 NHANES participants between the ages of 1 and 6, from 2001 to 2016.
Each survey consisted of an interview, including questions about demographics, socioeconomic status, and diet and health, as well as a physical examination. Parents or appropriate guardians provided survey information for the participants whose data was included in the study.
Which nutrients are young children missing?
Results from the survey found that the set of children between the ages of 1 and 6 did not have adequate amounts of specific nutrients in their diets, including calcium, docosahexaenoic acid (DHA), vitamin D, and iron.2 These findings remained consistent across a number of variables in regard to the nutritional status of children, such as race/ethnicity, and family income. The authors noted that these deficiencies are particularly worrisome, as children within this age bracket are undergoing rapid physical and cognitive growth that propels them from toddlerhood to kindergarten or first grade.
Calcium: Overall, 17 % of all the children in the study did not meet the estimated average requirement levels for calcium. Although this may not appear to be substantial, there was also a dramatic decrease in calcium intake as the children got older. A total of 3.6 % of the children, ages 1 to 3, had deficient calcium intake, which rose to 30.4 % for those between the ages of 4 and 6.2
DHA: Docosahexaenoic acid (DHA) is a type of omega-3 acid that is vital in early childhood cognitive development. Almost all the children in the study – 97 % to 99 % – were deficient in this particular nutrient. The recommended intake is from 70 mg per day to 100 mg per day, whereas the mean intake for the children in the study was only 24 mg per day.2 Adequate levels of DHA during the first six years are particularly vital, as cognitive development during this part of a child’s life will prepare them for preschool, kindergarten, and first grade.
Vitamin D: The researchers found that the percentage of children not meeting the estimated average requirement of vitamin D appeared to increase over time. A total of 79.2 % of children between the ages of 1 and 2 had inadequate vitamin D levels. This rose to 87.3 % for those between the ages of 2 and 3, and to 90.8 % for those between the ages of 4 and 6.2
Iron: Approximately 1.2 million children in the US between the ages of 1 and 3 have an iron deficiency. This is concerning, as iron is a vital nutrient for early childhood because it supports overall growth, brain development, and proper development of the immune system.2 The researchers found that Black children had the highest iron deficiency, at 11.7%, while white children had the lowest deficiency, at 10.7 %.
How can parents (and doctors) help?
As you may well know from your own experiences, getting children to eat a balanced, healthy diet often turns into a battle of wills. However, it is important that young children get adequate amounts of all their daily nutritional requirements. Therefore, parents should engage their children in making healthy food choices, starting at an early age. Some ways to do this can include:
- Expanding children’s palate for fresh fruits and vegetables once they begin solid food
- Providing several healthy snack options from which children can choose
- Let children help with making the grocery list, shopping, and preparing meals
- Use children’s supplements to fill in any nutritional gaps
However, the most important thing you can tell the parents or guardians of your pediatric patients in regard to the nutritional status of children is to build a positive relationship with healthy food. Having positive associations with fresh, unprocessed food that contains the nutrients needed for growth during children’s critical early years of life helps them succeed once they begin school and then later on in life.
- Centers for Disease Control and Prevention. National Center for Health Statistics about the National Health and Nutrition Examination Survey.
- Bailey ADL, Fulgoni Iii VL, Shah N, et al. Nutrient intake adequacy from food and beverage intake of US children Aged 1-6 years from NHANES 2001-2016. Nutrients. 2021;13(3):827.