Early Childhood Education

Nutrition and Early Childhood Education

Nutrition is one of the most important components in the health of young children, and poor nutrition can have a negative impact on several aspects of childhood health and development including learning. Undernutrition, often resulting from poverty and hunger, can lead to protein and/or energy malnutrition or a multitude of vitamin and mineral deficiencies. Although several nutrition efforts have focused on undernutrition, many countries are now faced with the alternative form of malnutrition—overnutrition. Children suffering from overnutrition and associated poor lifestyle behaviors are at an increased risk for obesity and chronic diseases including diabetes and cardiovascular disease. Worldwide trends in childhood overweight and obesity suggest that by 2010, using International Obesity Task Force definitions, 46 percent of school-age children in the

Americas will be overweight and one in seven will be obese. However, this issue is not limited to children in the Americas. By 2010, 41 percent of children in the Eastern Mediterranean, 38 percent of European children, 27 percent of children in the Western Pacific region, and 22 percent in Southeast Asia will be overweight, and one in ten children in the Eastern Mediterranean and European regions will be obese (Wang and Lobstein, 2006).

Recently, a national survey found that 66 percent of 2- to 4-year-old children consumed a diet that “needed improvement” and 8 percent consumed a diet that was classified as “poor.” Only 26 percent of children in this age group maintained a diet that was classified as “good” (Lin, 2005). There are several factors that have contributed to the current eating patterns of young children. Families have listed financial constraints and lack of knowledge regarding food preparation and storage as barriers to healthy eating (Hampl and Sass, 2001). Socioeconomic status greatly influences the types of foods families purchase. Lower-socioeconomic families are often at nutritional risk because they may not be able to purchase the proper types or amounts of food to support the growth and development of young children. For example, fresh fruits and vegetables are not regularly purchased by these families because they are perishable and perceived as more expensive. Fast food restaurants have become a growing concern in the American food culture because many fast foods are high in fat and/or sugar. Fast food restaurants are often attractive to parents of young children because they provide a cheap and quick source of food that their children often enjoy. Interestingly, fast food restaurants are more prevalent in lower-socioeconomic areas. An individual’s cultural identity also influences their food intake. For example, milk consumption is traditionally lower in African, Asian, and Mexican American cultures. Not only does an individual’s cultural identity influence their eating patterns, it can also influence their outlook on weight and health. Some individuals, such as Africans, Latinos, and Native Americans, view thinness with disease and overweight with health and beauty.

Healthy children between the ages of 2 and 6 years are recommended to eat in accordance with the Food Guide Pyramid for Young Children (1999) and the Dietary Guidelines for Americans (2005). The foundation of a healthy diet consists of whole grains, fruits, and vegetables along with regular consumption of low-fat and nonfat dairy products, lean meats, and beans. The guidelines provided below were designed for Americans, but they provide basic information that can be used to facilitate healthy eating patterns in all children. Young children should consume the following foods on most days:

• 6 servings of grains [one slice of bread, 1/2 cup of rice, or 1 ounce of cereal] of which half, or at least 3 servings, should be whole grain products

• 3 servings of vegetables [1/2 cup of raw or cooked vegetables or 1 cup of raw leafy vegetables]

• 2 servings of fruit [1 small piece of fruit, 1/2 cup of canned fruit, or 3/4 cup of 100 percent juice]

• 2 servings of dairy products [1 cup of milk or yogurt or 2 ounces of cheese]

• 4 to 6 ounces of lean meat, fish, poultry, or alternatives [e.g., peanut butter or eggs]

In addition to the specific guidelines above, other recommendations have been provided to help guide the development of healthy eating patterns in children. For example, although 100 percent fruit and vegetable juices can contribute to fruit and vegetable needs, most needs should be met by consuming whole foods rather than juices; therefore, the intake of juice should be limited to 4 to 6 ounces per day (AAP, 2001). Also, children should consume a limited number of foods that are high in fat and/or sugar. The term “sugar” refers to caloric sweeteners including sucrose (table sugar) and high fructose corn syrup (HFCS). Foods high in fat and/or sugar (e.g., cake and chips) contribute calories to the diet, but they are low in nutrients such as vitamins and minerals. Therefore, these foods should not make up a large component of a child’s diet. It is also recommended that children over the age of 2 years consume low-fat dairy options to reduce total and saturated fat consumption.

Beyond basic serving recommendations, it is imperative to address the appropriate means of providing food to children. When working with children, it is important to provide a variety of healthy options to the child. If a child is only provided cookies and chips, this is what the child will eat. However, if a child is provided healthier options, the child is more likely to maintain a healthy diet. It is the caregiver’s responsibility to provide a child with food options, and it is the child’s responsibility to determine what and how much to eat (Evers, 1997). To help prevent overeating, research indicates that children should be allowed to serve themselves or be provided small serving sizes (Orlet, Rolls, and Birch, 2003). Also, adults should encourage children to eat healthy foods without pressuring them to do so. Rather than forcing or bribing a child to eat a full serving of a new food, simply encourage the “one bite rule.” Children are born with an apprehension to new foods, and it may take five to ten exposures to a new food before the child accepts the new food. In addition, children are born with a preference for sweet and salty foods; therefore, foods with other flavors may take more exposure before they are accepted. Although it is recommended to limit the intake of foods high in sugar and/or fat, these foods should not be restricted from the child’s diet (Birch and Fisher, 1998). If the base of a child’s diet consists of healthy options, moderate consumption of appropriate amounts of less healthy foods is acceptable and will contribute to a healthy eating pattern later in life.

Within the school environment, teachers can promote healthy eating through a number of avenues. Teachers can encourage their schools to adopt a policy that provides children with healthy foods. Teachers can also address healthy foods in the classroom. A classroom garden can be beneficial in discussing food origins, sanitary food practices, and nutritional content. Teachers can also provide children the opportunity to try new foods. Healthy foods can be incorporated into classroom lessons or a “tasting party” can be offered for children. When providing foods to children in the classroom, early childhood educators must avoid common allergens (e.g., eggs, cow’s milk, wheat, soy, peanuts, tree nuts, fish, and shellfish) and foods that may cause choking (e.g., grapes). If it is not possible to incorporate foods into the classroom, try other food related activities such as making placemats or teaching children to set a table. Finally, teachers can promote healthy food intake among children by acting as good role models.

Teachers can also provide families with helpful information about healthy eating within the household. For example, teachers can encourage family meals. Eating as a family is beneficial because family meals are typically planned and therefore more nutritious than meals eaten on the go. It is also beneficial to include young children in the food purchasing and preparation processes as much as possible. For example, teachers can propose that families allow the child to pick a fruit or vegetable for dinner, perhaps as a part of a curriculum project connected with a community garden or other sources of local produce. Also, families can be encouraged to limit eating during sedentary behaviors such as watching television. Foods consumed during sedentary behaviors are often of little nutritional value, and children are often unaware of how much they are consuming during sedentary time. Teachers can also encourage parents to act as good role models. Adults can promote healthy eating behaviors by practicing appropriate eating patterns. Finally, specific programs such as Women, Infants, and Children (WIC), Head Start, and Food Stamps are available to provide valuable resources to eligible low-income families.

Eating patterns begin during the preschool years, and it is imperative to promote healthy behaviors during this important developmental period. By promoting healthy eating, early childhood educators can have a significant impact on the health of children immediately and over the life span.

Further Readings: American Academy of Pediatrics (AAP) (2001). Policy statement: The use and misuse of fruit juices in pediatrics. Pediatrics 107, 1210-13; Birch, L., and J. Fisher (1998). Development of eating behaviors among children and adolescents. Pediatrics 101, 539-49; Evers, C. (1997). Empower children to develop healthful eating habits. Journal of the American Dietetic Association 97, S116; Hampl, J., and S. Sass (2001). Focus groups indicate that vegetable and fruit consumption by food stamp-eligible Hispanics is affected by children and unfamiliarity with non-traditional foods. Journal of the American Dietetic Association 101, 685-687; Huettig, C., S. Rich, J. Engelbrecht, C. Sanborn, E. Essery, and N. DiMarco et al. (2006). Growing with EASE: Eating, Activity, and Self-Esteem. Young Children 61, 26-31; Lin, B. (2005). Nutrition and health characteristics of low-income populations: Healthy Eating Index. Agriculture Information Bulletin, 796-91; Orlet, F., B. Rolls, and L. Birch (2003). Children’s bite size and intake of an entree are greater with large portions than with age-appropriate or self-selected portions. American Journal of Clinical Nutrition 77, 1164-70; USDA (1999). Food Guide Pyramid for Young Children. Available online at http://www.usda.gov/cnpp/KidsPyra/; USDA (2005). Dietary Guidelines for Americans. Available online athttp://www.healthierus.gov/dietaryguidelines/; Wang, Y. and T. Lobstein (2006). Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity 1, 11-25.

Eve Essery, Nancy DiMarco, and Shannon S. Rich