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Malnutrition

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  • What do parents need to know about the nutrition of preschoolers?
  • Basic requirements for catering for preschoolers, requirements for creating menus for children of different ages, physiological requirements for energy and nutrients for children from 0 to 7 years old, recommended calorie distribution between meals, a list of foods that are not allowed to be used in nutrition of children are set out in SanPiN 2.4.1.3049-13 "Sanitary and epidemiological requirements for the device, content and organization of the working hours of preschool educational organizations." The same standards must be followed by parents for catering to preschool children in the family.

    The nutrition of the child must meet the following basic principles:

    - nutrition should be varied, balanced, to provide the body with all the necessary nutrients, proteins of animal and vegetable origin, fats, carbohydrates, macro- and micronutrients should be present in the diet. Monotonous food quickly "palls", leading to a decrease in the excretion of digestive juices, a decrease in the digestibility of nutrients, that is, to malnutrition and disruption of the body. Vegetarianism is unacceptable for children, since protein starvation leads to impaired physical and mental development. In order to provide the body with all the substances necessary for growth and development, the daily menu of the child should have different foods and dishes - meat, fish, dairy, cereals and cereals, fruits and vegetables, bread. It is very important from early childhood to form a child’s diverse taste horizons so that he likes a variety of foods and dishes,

    - food should be regular, intervals between meals should not exceed 4 hours. Strict adherence to meal times and intervals between them is a prerequisite for normal gastric secretion. If this requirement is not observed, digestion worsens and, accordingly, the absorption of nutrients by the body, and appetite decreases. Children who do not observe the regime have a higher level of anxiety, fatigue, they often have conflicts with their peers, it is more difficult for them to learn. The last meal (no later than 1.5–2 hours before bedtime) should include only low-calorie foods (milk, sour-milk drinks, fruits, juices), fried foods, foods rich in fats, crude fiber, spices, table salt, are prohibited

    - nutrition should be consistent with the child’s energy expenditure throughout the day. The energy value (calorie content) of the daily diet is distributed between meals as follows: breakfast 20-25%, lunch 30-35%, afternoon tea 15%, dinner 20-25%. According to experts, regular excess of caloric intake by 10-15% (a few "extra" buns or sweets) 3 times increases the likelihood of the student becoming overweight. A “full” child is at risk of developing various serious diseases, including cardiovascular diseases,

    - food should be safe. Thermal processing of food products has three goals: to ensure sanitary and epidemiological safety of products by destroying pathogens, increase the digestibility of food substances, and improve the palatability of products. Children should not be given coarse, hard to digest food (fatty, overcooked), as well as food containing many hot spices, very sour and salty. The main methods of cooking for children are: cooking, frying, stewing, baking, steaming. The term for the implementation of ready meals in the catering system for children should not exceed 2 hours from the time they are prepared. Adults are required to monitor the expiration date, storage conditions of the products, the information indicated on the product packaging, as their violations can cause significant harm to health. Caution is advised that the child try exotic foods and dishes. Of course, such an experience helps to expand the culinary "horizons", but, at the same time, it can cause an allergic reaction in children. To ensure food safety, it is necessary for children to instill hygiene skills, a culture of behavior and etiquette (washing hands before eating, using cutlery, napkins, eating neatly, talking quietly, etc.),

    - nutrition should cause pleasant sensations and positive emotions. The appearance of the dishes, their taste, table setting - everything should cause positive emotions in children. The food is served hot, the temperature of the first and second courses is 60-65 degrees. It is hot food that stimulates the secretion of digestive juices, is better absorbed, is more fully used by the body, and gives a feeling of fullness. The situation when eating should be calm, the furniture is comfortable, appropriate for the growth of the child. The recommended duration of a meal is 20 minutes. The child should eat food slowly, chewing thoroughly. However, lengthening the intervals of food intake beyond the specified time should not be, in connection with the rapid development of fatigue in the child with a uniform form of activity. Thorough chewing of food will avoid overeating and ensure the intake of more beneficial substances into the body. Overeating is one of the most common causes of overweight and digestive problems. To avoid overeating, meals should be stopped when you are still experiencing a slight feeling of hunger. You can’t eat while reading books, sitting by the computer or TV.

    For reference.

    Food products that are not allowed to be used in the nutrition of children in preschool educational organizations

    Meat and meat products:

    - meat of wild animals,

    - collagen-containing raw materials from poultry meat,

    - meat of the third and fourth category,

    - meat with a mass fraction of bones, adipose and connective tissue of more than 20%,

    - offal, except for the liver, tongue, heart,

    - blood and liver sausages,

    - meat of waterfowl.

    Dishes made from meat, poultry, fish:

    - brawn, meat trimmings, diaphragms, rolls of pulp heads,

    - dishes that have not undergone heat treatment, except salted fish (herring, salmon, trout).

    - canned goods with violation of the tightness of cans, bombing cans, "crackers", cans with rust, deformed, without labels.

    - cooking fats, pork or lamb, margarine (margarine is allowed only for baking) and other hydrogenated fats,

    - butter fat content below 72%,

    - fried in fat (deep-fried) foods and culinary products, chips.

    Milk and dairy products:

    - milk and dairy products from farms unsuccessful in the incidence of farm animals,

    - milk that has not passed pasteurization,

    - dairy products, curd cheese using vegetable fats,

    - ice cream (based on vegetable fats),

    - cottage cheese from unpasteurized milk,

    - flask sour cream without heat treatment,

    - eggs of waterfowl,

    - eggs with contaminated shells, with a notch, "tech", "fight",

    - eggs from farms unsuccessful for salmonellosis,

    - cream confectionery (pastries and cakes) and creams.

    Other products and dishes:

    - any food products of home (non-industrial) manufacture, as well as those brought from home (including during the organization of celebrations, birthday parties, etc.),

    - first and second courses based on dry instant food concentrates,

    - cereals, flour, dried fruits and other products contaminated with various impurities or infected with barn pests,

    - mushrooms and culinary products made from them,

    - kvass, carbonated drinks,

    - vinegar, mustard, horseradish, hot pepper and other hot seasonings and foods containing them, including hot sauces, ketchups, mayonnaises and mayonnaise sauces,

    - pickled vegetables and fruits (cucumbers, tomatoes, plums, apples) using vinegar, which have not undergone heat treatment before issuing,

    - kernels of apricot kernel, peanuts,

    - caramel, including candy,

    - products, including confectionery containing alcohol, koumiss and other dairy products with an ethanol content (more than 0.5%).

    Hypotrophy

    Chronic eating disorder, which reduces food tolerance and is accompanied by the development of a deficit in body weight.

    • violation of the digestion, absorption and absorption of nutrients,
    • increased need for nutrients and energy,
    • hereditary and congenital metabolic disorders.

    Symptoms (general):

    • underweight
    • thinning of the subcutaneous fat
    • I Art. lack of body weight in relation to the proper 10-20%, subcutaneous fat layer is developed moderately, the child does not lag behind in growth, mental development corresponds to age,
    • II Art. body weight deficit of 20-30%, thinning of the subcutaneous fat layer, skin is pale and dry, growth is less than the average age norm, lag in psychomotor development, sleep disturbances, increased irritability, decreased immunity.,
    • III art. body mass deficit of more than 30%, subcutaneous fat layer is absent, body temperature is lowered, skin is inelastic, dry, brittle, psychomotor development stops, morbidity is sharply increased with a tendency to chronic infections.

    Paratrophy

    Chronic eating disorder, in which body weight remains close to the average age norm, however, there are clinical signs of eating disorder.

    • excess carbohydrate in the child’s diet,
    • abnormalities of the constitution (exudative-catarrhal and lymphatic-hypoplastic diathesis).

    Treatment of malnutrition in children (malnutrition in children)

    The basis of the treatment of hypotrophy is a step-by-step diet therapy with a gradual increase in the volume and calorie intake of food taken by the child, as well as symptomatic therapy if necessary.

    Paratrophy

    Chronic eating disorder, in which body weight remains close to the average age norm, however, there are clinical signs of eating disorder.

    • excess carbohydrate in the child’s diet,
    • abnormalities of the constitution (exudative-catarrhal and lymphatic-hypoplastic diathesis).

    Symptoms and clinical manifestations of malnutrition in children (failure of the diet in children)

    The skin is pasty, a pronounced subcutaneous fat layer, the child is inactive, causeless anxiety, increased irritability, sleep disturbance, unstable stool, frequent infections.

    Diagnosis of malnutrition in children (failure of the diet in children)

    Based on the collection of anamnesis, assessment of the physical development of the child, comparison of actual body weight with the average age norm, measurement and assessment of the subcutaneous fat layer, assessment of neuropsychic development and the condition of the child

    Treatment of malnutrition in children (malnutrition in children)

    Diet therapy, which includes balanced nutrition, an increase in the number of fruits and vegetables, vitamin therapy, the appointment of physiotherapy exercises, massage.

    Chronic eating disorder characterized by overweight due to increased deposition of adipose tissue.

    • poor nutrition (the most common reason is an excess of simple carbohydrates in the diet),
    • lack of exercise
    • mental disorders and other disorders of the central nervous system,
    • endocrine diseases.

    Symptoms (general)

    overweight

    • I Art. excess body weight 10-30%,
    • II Art. excess body weight 30-50%,
    • III art. excess body weight 50-100%,
    • IV Art. excess body weight of more than 100%.

    Manifestations of obesity are the same for any degree, they differ only in their severity. Fatigue, decreased exercise tolerance, frequent infections, unstable stool.

    Diagnostics

    Based on data from examination and determination of excess body weight as a percentage of the average age norm.

    The main thing is the normalization of nutrition, a decrease in the amount of carbohydrates in the diet, an increase in the number of foods containing fiber, in some cases enterosorbents, appetite suppressing drugs can be used, most patients also require the help of a qualified psychologist.

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    A lot of sweets are not allowed for children!


    The question of the need to introduce sweets into the diet of children worries many parents. A huge variety of confectionery, sweets, sweet bars, bright packaging and active advertising will leave few indifferent. Excessive consumption of sweets by children greatly increases the risk of developing diseases such as:

    • caries,
    • type 2 diabetes
    • obesity,
    • allergy,
    • stomatitis - inflammation of the oral mucosa,
    • gastrointestinal dyspepsia,
    • violation of the cardiovascular system.

    With the systematic use of foods with a high sugar content, especially sweets for absorption and toffee, an acidic environment is created in the oral cavity that is favorable for the development of many pathogenic bacteria. And sugar particles stuck between the teeth in the enamel cracks are a nutrient substrate for cariogenic microbes.

    The resorption of candies in large quantities leads to trauma to the oral mucosa and tongue, which provokes inflammatory changes and easy penetration of infectious agents into the tissues.

    Chocolate bars, bars, cakes, cookies, especially with additives, are high in calories. При их изготовлении используют кондитерские жиры, ароматизаторы, консерванты, красители, усилители вкуса — вещества, которые крайне нежелательны для употребления человеком любого возраста. Добавки провоцируют аллергические реакции, а высокое содержание сахара нарушает жировой и углеводный обмен.

    Sweet carbonated drinks are extremely harmful, not only as sources of simple sugars and harmful additives, but also as the strongest digestive system irritants. Bubbles of gas provoke an increase in the acidity of the gastric juice, spasm of the gallbladder and bile ducts, ducts of the pancreas, provoke flatulence. In Coca-Cola and similar drinks, the sugar content is ten times higher than normal.

    Excessive consumption of chocolate, cocoa, coffee and other caffeinated foods and drinks causes a temporary increase in blood pressure, increased heart function, leads to neuropsychic overstrain and increased excitability, depleting the cardiovascular and nervous systems.

    High doses of simple sugars contained in sweets provoke hyperglycemia - an increase in blood glucose. The hard work of the pancreas to utilize excess sugar leads to its depletion. At the same time, the receptors in the tissues become insensitive to its hormone - insulin. All this leads to an increased risk of developing diabetes mellitus and metabolic syndrome. Excess glucose is stored in the body in the form of fat deposits, causing the development of nutritional obesity.

    But do not forget that glucose is the most important energy substrate for all cells of the child’s body. Without it, normal functioning of the nervous system is impossible, which is especially important when learning and mastering new skills that children receive at school. In addition, “sweet” is a source of the hormone of pleasure, serotonin, which is necessary for the child due to stress, sometimes associated with attending school.

    In the schoolchildren’s diet, the inclusion of sweets in small quantities is acceptable. Purchased sweets are best replaced with homemade marshmallows, marmalade, marshmallows, dried fruits, sweet fruits, jellies, compotes and juices. The share of refined sugar in a child’s diet can be replaced with honey, which is rich in fructose, trace elements and vitamins.

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