Nutrition is both the process by which humans take in and utilize food and the study of diet as it relates to health.

With the proliferation of fast food restaurants, the number of junk food commercials on television, and the increased trend toward eating out, it is moredifficult than ever for parents to ensure that their children maintain a nutritious diet. In recent decades, increasing affluence and the widespread availability of vitamin-enriched foods have shifted the focus of nutritional concerns in the United States from obtaining minimum requirements to cutting downon harmful elements in one's diet. According to a 1988 report from the officeof the U.S. Surgeon General, health problems are more likely to be caused bynutritional excesses and imbalances than by deficiencies. In other words, parents need to be as concerned about high levels of fat, cholesterol, sugar, and salt as about adequate intake of vitamins, minerals, and other nutrients.

The American Academy of Pediatrics, the National Academy of Sciences, the American Heart Association, and other nutrition-oriented organizations agree that fat should not account for more than 30% of the calorie intake of childrenover the age of two, and saturated fat should account for under 10%. The maindietary sources of saturated fat include whole milk, cheese, hot dogs, and luncheon meats. Recommendations for dietary change include switching to 1% orskim milk, low-fat cheese, and meats from which the fat can be trimmed. (Because fat is important for growth, experts also caution that fat intake shouldnot be lowered to under 25% of daily calorie intake, and that parents of children under two should not restrict fat in their diets.) Hardening of the arteries and heart disease have been linked not only to the conversion of saturated fats into cholesterol but also to cholesterol that comes directly from food (dietary cholesterol), often found in the same foods that are high in saturated fat. Egg yolks are the primary source of dietary cholesterol, and theirconsumption should be monitored in children as in adults.

The amount of refined sugar in children's diets--typically accounting for 14%of calorie intake by adolescence--is another cause for concern. Although sugar is known to cause tooth decay and may be associated with behavior problems, the greatest danger in consuming foods high in added sugar is that these "empty calories" will replace the more nutritious foods that children need in order to maintain good health. (Soft drinks, perhaps the single greatest source of refined sugar in the diet of children and teenagers, get virtually all their calories from sugar and offer no nutrients whatsoever.)

Another element that needs to be restricted in children's diets is the intakeof sodium through salted foods. Sodium has been closely linked to hypertension (high blood pressure), which increases a person's risk of heart disease and strokes. It has been determined that 18-year-olds need only 500 milligramsof sodium daily. However, the average two-year-old already consumes more thanfive times that amount (2,670 milligrams), and this figure rises to 3,670 milligrams by the age of 17. The National Academy of Sciences recommends limiting sodium intake to 2,400 milligrams daily (if possible, 1,800 milligrams). Contrary to what most people might think, the vast majority of sodium enters aperson's diet through salt that is added in food preparation rather than table salt used when a person is eating.

In addition to limiting the amounts of fat, cholesterol, salt, and sugar in children's diets, health authorities also recommend that parents concerned about nutrition ensure that their children obtain a generous supply of complex carbohydrates (found in foods such as beans, potatoes, whole-grains, and pasta) and have at least five servings of fresh fruits and vegetables daily.

A special problem that may affect childhood nutrition is the presence of foodallergies, which are more common in children than in adults. They are most likely to begin when a child is very young and the immune system is still sensitive--most begin in infancy. Food allergies also tend to run in families: if one parent has food allergies, a child has a 40% likelihood of developing one. This figure rises to 75% if both parents have allergic sensitivities to food. Common symptoms of food allergies include hives, rashes, swellingof the eyes, lips, and mouth, respiratory symptoms, and digestive problems. Foods that most often produce allergic reactions in infants are cow's milk, soy products, and citrus fruits. Other common childhood allergens include wheat, nuts, chocolate, strawberries, tomatoes, corn, and seafood. A widely used method for detecting food allergies is to temporarily place children on dietsfree of known allergy-causing foods and then add one "suspect" food at a timefor a week or so and observe the reaction. Once the causes of food allergiesare known, the best treatment method is to remove those foods from the child's diet. If the causes of a food allergy cannot be determined, antihistaminescan be used to reduce the symptoms of allergic reactions. In time, childhoodfood allergies are often outgrown.

Feeding a child with food allergies is a challenging but not impossible taskfor parents. A variety of foods can be substituted for those to which a childis allergic: soy products for milk and other dairy products; carob for chocolate; and, in the case of wheat allergies, products or flour made from grainssuch as rice or oats.

Many authorities, including the American Academy of Pediatrics, agree that healthy children receiving a well-balanced diet do not need to take nutritionalsupplements. Nevertheless, some pediatricians still recommend vitamins for children until they are eating solid foods. Special situations that may call for supplements include vitamin K deficiencies in low birthweight babies; iron deficiency in young children or adolescent girls; weight-reduction orallergy diets that may cause vitamin deficiencies; vitamin B12 deficienciesin children from strict vegetarian families who do not receive animal proteinfrom dairy products; and various illnesses, including metabolic disorders. Recommendations for supplements are universally accompanied by the precautionthat they should not be considered substitutes for an adequate diet.

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