Nutrition, health and schoolchildren

Abstract

SUMMARY 1 NUTRITIONAL REQUIREMENTS OF CHILDREN 1.1 Dietary reference values1.2 Fluid requirements1.3 Growth and development 2 THE NATIONAL DIET AND NUTRITION SURVEY OF YOUNG PEOPLE 2.1 Types of food eaten2.2 Energy intake2.3 Macronutrient intakes2.4 Micronutrient intakes and status2.5 Dietary supplements2.6 Vegetarians/vegans2.7 Regional and socio‐economic differences 3 PHYSICAL ACTIVITY PATTERNS IN CHILDREN 3.1 Physical activity patterns in the UK3.2 Health benefits and effecting change 4 HEALTH IMPLICATIONS OF CHILDREN's DIETS AND ACTIVITY PATTERNS 4.1 Prevalence and implications of childhood obesity4.2 Risk factors for cardiovascular health4.3 Bone development4.4 Cancer4.5 Iron deficiency anaemia4.6 Oral health4.7 Food allergies and intolerance4.8 Eating disorders and restrained eating 5 SOCIAL AND CULTURAL INFLUENCES 5.1 Impact of television advertising5.2 Other social influences5.3 Teenage pregnancy5.4 Smoking, alcohol and drug use 6 TEACHING ABOUT NUTRITION AND HEALTH IN SCHOOLS 6.1 The formal curriculum6.2 The ‘hidden’ curriculum 7 IMPROVING THE HEALTH AND NUTRITIONAL STATUS OF CHILDREN 7.1 UK initiatives in schools7.2 School lunches7.3 School initiatives in North America and elsewhere7.4 Non‐school initiatives7.5 Welfare programmes for mothers and young children 8 CONCLUSIONS REFERENCES LIST OF BRIEFING PAPERS Summary Over the last 50 years, there has been a change in the predominant concerns about the diets and health of school aged children. Historically, the focus has been on the provision of sufficient nutrients and energy in relation to current and future needs, but providing dietary balance and encouraging less sedentary lifestyles are now viewed as the main priorities.The government report, the National Diet and Nutrition Survey: Young People aged 4–18 years, which was published in 2000, provides comprehensive information on the dietary patterns, nutrient intakes, nutritional status and physical activity patterns of young people in Britain today. This survey, in common with a number of other recent reports and papers, has identified the public health implications of the diet and lifestyle of schoolchildren of all ages. With the exception of very young children (4–6 years old), between 40–69% of children in Britain are largely inactive, spending less than one hour a day participating in activities of moderate intensity. These findings are also consistent with a number of other recent reports concerning the increasing prevalence of overweight and obesity in children. This situation mirrors that in adults and is likely to have the same fundamental causes.Consistent with data from the National Food Survey, it appears that over recent years there has been a reduction in energy intake and fat intake as a percentage of energy, with a corresponding increase in the proportion of energy derived from protein and carbohydrate. The average fat intake of children is in line with recommendations for adults, although their average intake of saturated fatty acids still exceeds government targets for adults. Salt and sugar intakes were also high in many children.Again, like many adults, British children are typically eating less than half the recommended five portions of fruit and vegetables a day. One in five (4–18 year olds) ate no fruit at all during an average week.There is evidence of low micronutrient intakes or status in some sub groups, for example poor vitamin D status, particularly in a proportion of older children. There is also evidence of low status of some vitamins in children from low income households and low intakes of some minerals, particularly in the older children: zinc, calcium and magnesium in boys and girls; and iron, iodine and copper in the girls. In particular in girls, there was some evidence of poor iron status.Clearly, these issues are worthy of attention because poor eating and physical activity habits in childhood may increase the risk of health problems in later life. Diet during childhood is a factor to varying degrees in the development of a number of diseases, either in childhood itself or during adult life, such as obesity, iron deficiency anaemia, dental caries, coronary heart disease, hypertension, osteoporosis and cancer. There is some evidence to suggest that health traits present in childhood tend to track into adult life, including body weight, blood levels of cholesterol, other blood lipids and insulin, and blood pressure. The extent to which genetic and environmental factors influence the development of diseases in later life remains unclear, but adoption of sensible eating habits and an active lifestyle early in childhood are considered important health strategies.Improving the health and nutrition of children should remain a priority for the government, health professionals, the food industry and teachers alike. The Healthy Schools Programme, re‐introduction of minimum nutritional standards for school lunches, compulsory teaching of food and nutrition in the Science; Design and Technology; and Personal, Social and Health Education programmes of study, together with other government initiatives such as the Wired for Health website, the School Fruit Scheme and School Travel Plans (encouraging walking and cycling) will contribute towards empowering children with knowledge and opportunities to make informed choices for their future health.