Nutritional Needs of Children

Nutri onal Needs of Children

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Nutri onal Needs of Children

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Contents 1. Importance of Nutri on ........................................

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2. Understanding Nutri on .......................................

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 Carbohydrates ................................................

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 Proteins ..........................................................

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 Fats .................................................................

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 Vitamins..........................................................

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 Minerals..........................................................

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3. Enhancing Nutri on

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4. Other essen als

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 Water

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 Sleep

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 Sunlight

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 Physical Ac vity

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5. Other Healthy Prac ces

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 Hygiene & Sanita on

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 Food Handlers’ Hygiene

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 Food Storage & Safety

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Annextures

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Chapter

Importance of Nutri on

By ra fying the United Na ons Conven on on the Rights of Child (UNCRC), most countries showed their commitment to uphold every child’s right to develop to their full poten al. One of the fundamental rights is the “Right to Survive and Develop”.

Children cannot survive, grow and develop without nutri ous food and therefore it is a basic necessity to fulfil this fundamental right. A balanced, nutri ous menu helps children develop healthily, both physically and mentally.

India leads the world in the number of children living in street situa ons.

Street living is highly challenging where even basic needs like clean, adequate nutri ous food and water are not met. Studies have shown that children on the streets miss meals and whatever food they manage may fill their stomach somewhat but is unhygienic, and u erly lacks in nutri on.

The Rainbow Homes Program (RHP), through its residen al homes and community-based care programs reaches out to marginalized and vulnerable children; those living in street situa ons. Recognizing the importance of nutri on during developmental years, RHP is commi ed to providing freshly cooked nutri ous meals daily in the Rainbow homes and nutri ous ra on kits to the Rainbow children in the community.

This booklet is aimed to be used as a reference by caregivers and organiza ons that work for the rights of children to understand nutri on, health issues caused by their deficiencies and the specific nutri onal needs of children at various ages and how best to ensure it.

Let’s begin by understanding how we recognize if a child is well nourished or not. The following are the ways well-nourished and poorly nourished children will differ in behaviour and day-to-day adaptability to the demands in growing years.

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Well-nourished child More alert and more a en ve & ac ve Be er able to benefit from learning opportuni es Resistant to infec ons Recover faster from injury and illness.

Brighter skin, hair, teeth More likely to succeed in school and sports

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Under nourished child May be dull quiet and withdrawn Maybe hyperac ve and disrup ve or irritable May develop slower with developmental delays More likely to catch infec ons and fall ill frequently.

Underweight for the age Maybe obese children may be slower, and unable to par cipate in all ac vi es, and this can affect mental health.

Our daily rou ne includes various ac vi es and bodily processes such as breathing, sleeping, food diges on etc. which require energy. The energy for these processes is called the Basal Metabolic Rate. Children undergo rapid growth and have a higher basal metabolic rate than adults. They do more ac vi es involving physical exer on, such as running around, jumping, playing sports, etc. and therefore need addi onal energy. For this, they need energy and micro-nutrients such as minerals and vitamins. This requirement is fulfilled by the food that they eat.

Most studies say that a healthy breakfast is associated with improvement in cogni ve func on (memory, focus) and mood. Healthy meals are directly linked to higher school a endance and lower dropout rates.

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Chapter

Understanding Nutri on

Food has been categorized into five food groups based on their chemical structure.

Vitamins

Proteins

Foods can also be classified depending on their func ons:

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CARBOHYDRATES Carbohydrates are the main source of energy and they should provide 55-65% of our total energy requirement.

There are two types of carbohydrates:  Simple Carbohydrates- Have sugars and starches with very less or no fibres  Complex carbohydrates- Have less sugars, more fibres and moderate starches.

Simple Carbohydrates: Provide easy and instant energy .  Simple sugars: Table sugar, jaggery, honey, fruit juices, syrups, molasses, brown sugars.  Processed foods made with added sugar: Candy, soda, jams, jellies, sauces.  Refined sugar foods: Cookies, cakes, all food made from maida (refined flour) They provide pleasure and energy for a short period but lack essen al nutrients for building the body and immunity.

Any surplus energy gets stored in the body as Glycogen and fat under the skin, leading to overweight and obesity.

Being overweight and obese can lead to various health-related problems, including poly-cys c ovary disease, irregular periods in girls due to hormonal imbalance, hypertension, diabetes, hair fall, dull skin, bri le nails, and poor performance in ac vi es. All these, then result in decreased confidence levels. It is therefore important to limit the intake of simple carbohydrates to prevent these condi ons in growing ages

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Complex Carbohydrates- Complex carbohydrates contain complex sugar, fibres, vitamins, and minerals like calcium, iron, and others essen al for daily metabolic processes. They are considered good carbohydrates as they provide sustained energy, manage weight, promote sa ety, and assist in sugar management.

Foods that are rich in complex carbohydrates include:  Whole grains: Wheat, Maize, Unpolished rice, Daliya. Polished and refined grains lose essen al vitamins in the outer layer of grains Therefore, whole grains and unprocessed foods are healthier.  Millets: Jowar Bajra, Ragi, Rye  Fruits - Fruits contain fructose sugars and Fiber also contains an oxidants and some vitamins or minerals.  Starch-rich root vegetables -such as potatoes, sweet potatoes, and yams.

However, they don’t have much fibre content.  Fruits, salads, and vegetables have fewer sugars and more fibers so are beneficial for promo ng regular bowel movements. Providing a feeling of sa ety and helping in controlling caloric intake. They help to reduce the risk of obesity, lower blood sugar levels, cholesterol.

The recommended amount of carbohydrate intake for children per dayAge (Years) 4 to 8 9 to 13 14 to 18

Boys 25 g 31 g 38g

Girls 25 g 26 g 26g

Fibre in Foods: There are several foods rich in fibre by themselves or in combina on with other fibre-rich foods that can fulfil the daily requirements of different ages of children.

Dietary fiber or roughage is the por on of plant-derived food that cannot be completely broken down by human diges ve enzymes.

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Fibre rich foods are : Fruits - apple ( 5.7 gm), guava ( 9 gm), and pomegranate( 7 gm); Vegetables - cabbage(33 gm), carrot(55gm), pumpkin(83 gm) and spinach(41gm). Sweet potato is considered healthier than normal potato and contains 4.9 gm of fibre.

Len ls- Half a cup of cooked len ls provides 6.6 gm , kidney beans provides 5.8 gm of fibre.

How can I improve my fibre intake?  By adding fibre-rich vegetables into len ls,  Having salad or raita with both meals  Have one or two fruit per day as mid meal Ge ng the right balance of sugars, starches, and fibre is key to keeping blood sugars in a healthy range.

Choose healthy carbs.  Improve intake of whole grains - wheat with bran, millet and rice (unpolished) or roti made of wheat (no added maida), jawar, ragi, and bajara can be included in alternate ways.  Ensure 200 gm of vegetables, 2 salads(200gm) and 2 fruits (seasonal, locally available) per day.

1 gram of carbohydrate is 4 kcal 1 gram of Fiber is 2 Kcal

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PROTEINS Protein is the building block of the body as it is essen al for the forma on of cells of blood, bones, muscle, skin, hair, nail and enzymes and the con nuous produc on of new cells in the body. It also supplies the energy and strength needed for daily movement and ac vity, including recovery and repairing ssues in the muscles, blood, organs and bones. Protein also keeps blood sugar levels steady.

Proteins are made up of amino acids and are classified into three categories depending on their requirement.

Non-essen al amino acids- which our bodies can produce, even if not consumed in the food.

Condi onally Essen al - In some condi ons when the protein cannot be synthesized by the body such as during illness and stress.

Essen al amino acids- are not produced by the body and so must come from food.

Foods that contain high protein Eggs  Dairy Products- Milk, Curd, Paneer, Cheese  Nuts & Seeds - Peanuts, almond, cashew, sunflower seeds, ramdana, sesame, flax seed, coconut  Meat & Chicken  Fish & seafood like prawns.

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 Pulses and len ls like chickpea, rajma, moong, moth, chana, chole, green peas, all daal like masoor dal, chana dal, etc  Soy products- Soy milk, Soy chunks, soy granules, soy a a Protein deficiency-This essen al macro-nutrient is so important for children that it affects every single part of the body. The signs of deficiency are  Fa gue, weakness,

 Anaemia

 Poor concentra on.

 Slow growth,

 Poor wound healing,

 Low immunity

 Stunted growth

 Hair Fall

 Bri le hair and nails

 General pain in the body along with pain in the joints.

Two severe condi ons that can occur due to a proteindeficiency areMarasmus - a severe deficiency of carbohydrates, fats and protein that tends to develop in infants and young children. It causes weight loss and deple on of fat and muscle. In marasmus, most of the body’s subcutaneous fat and deeper fat stores are lost, making the ribs, hips, facial bones, and spine visible through the skin.

Kwashiorkor usually shows up as swelling. Kwashiorkor may also result from an acute illness, gastroenteri s or another infec on. The abdomen protrudes because abdominal muscles are weakened. The skin is dry, thin, and wrinkled. Hair can become thin, reddish brown, or grey or hair loss can occur. The child looks lethargic and sick.

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While protein deficiency can lead to malnutri on, excess can also have side effectsWeight gain: Excess protein means excess calories. If a child can’t burn the calories off, the body stores them as Fat. Organ damage: High protein levels can strain the kidneys, making it harder to filter out the waste, causing dehydra on and kidney stones. High levels of nitrogen can also decrease the body’s ability to break down nutrients.

For Easy, cheap and high protein recipes, refer to annexure 1

Age Infants 1-3 years 4-8 years 6-8 years 9-13 years 14-18 years (boys) 14-18 years (girls) 1gm protein gives 4kcal

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Suggested amount of protein intake per day 8-10.5 g 11.3 g 16 g 19 g 34 g 52 g 46 g

FATS Fat is an essen al macro-nutrient. It is a concentrated form of energy where 1 gm Fat gives 9 kcal. Besides supplying fuel for the body, fats help in the following ways:  Help the body absorb fat-soluble vitamins (vitamins A, D, E, and K), which can only be absorbed if there’s fat in a person’s diet.  They are the building blocks of hormones.  It acts as protec ve cushion which covers the organs in trunk area.  It acts as blanket, protec ng from cold and heat  It is important for brain health.  It helps by making us feel full, preven ng us from overea ng.

Fats can be:  Visible Fats- Fats that can be easily seen and iden fied ; such as oils, ghee, bu er etc.  Invisible Fats- Fats that are present in foods such as peanuts, coconuts, fruits, and nuts like almonds, pistachios, cashews, vegetables and fish; milk, cream.

Fats are divided into 3 categories: Saturated Fats Solid at room temperature Sources: Animal Sources Beef, Pork, lamb, poultry with skin, lard, cream, bu er, cheese, and whole milk; Fried and baked foods Full-fat ice cream and other desserts

Unsaturated Fats Liquid at room temperature Sources: Plant-based oils: Peanut oil (Peanut Bu er), Soybean Oil, Mustard oil, Safflower oil, Corn oil Seeds: Sesame, Sunflower, Pumpkin Flaxseeds; Nuts: Almond, Walnut Fish They raise the bad cholesterol in the They increase good cholesterol blood: LDL - Low-density lipoprotein in the blood: HDL – High-Density Lipoprotein Benefits: Gives energy Benefits: Important for Brain Development

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Trans fats - These are fats that raise bad cholesterol and lower good cholesterol increasing the risk of type 2 diabetes.

Foods that have trans fats and should be avoided include  Solid fats are popularly known as Vanaspa which is commonly used in bakery products, sweets, and snacks.  Naturally occurring trans-fat in meats such as cows, sheep and goat meat.  Whole milk cheese, full fat cream , full-fat curd and coconut oil.  Biscuits/savouries, cakes, pastries, pa es, French fries, samosa, jalebi, gulab jamun, street food like pakoras, aloo kki, bhatura etc. prepared with repeated frying of the same oil.

Tips to reduce unhealthy fat  Use filtered oil rather than refined oils.  Use mustard oil, peanut oil or sesame oil to improve omega.  Roast or shallow fry instead of deep fry.  Avoid rehea ng the same oil repeatedly.  Remove fats (skin) from chicken or mu on.  Avoid processed foods.  Use ghee and bu er only for topping.

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VITAMINS Vitamins are essen al nutrients that help in body metabolism and are important for growth and development. They are called “Essen al” as most vitamins are not synthesized in the body (except Vit D) so must be taken from food. There are 13 essen al vitamins - A, C, D, E, K, and the B complex vitamins. They are needed in small quan es, hence called micronutrients. Each has a different role in maintaining health and bodily func on.

Water-soluble vitamins Fat-soluble vitamins Vitamins get washed away if taken Are absorbed in the body in the in higher quan es and cannot be presence of fats. They can be stored in the body for 30 to 90 days. stored in the body.

They func on as co-enzymes They pose a greater risk for toxicity (helps in Carbohydrates, Protein, when consumed in excess. Ea ng a fats diges on) that help the body normal, well-balanced diet will not obtain energy from food. They are lead to toxicity in otherwise healthy important for normal appe te, good individuals. However, taking vitamin vision, healthy skin, nervous system, supplements that contain megadose of vitamins A, D, E and K may and red blood cell forma on. lead to toxicity.

B-complex Vitamins and Vitamin C Vitamins, A, D, E, and K are fatare water-soluble. soluble.

Vitamin A The body cannot produce vitamin A, so it is provided through food.

Func ons  Essen al for eyesight, especially night vision  Keeps the skin in the mouth, respiratory tract and urinary tract moist.  Builds immunity

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Deficiencies  Dry eyes, Lips  Night Blindness  Dry, thick or scaly skin  Impaired immunity

Vitamin B

Sources  Carrots are the most popular and rich source  Oily fish, Egg yolk  Full cream dairy products, bu er, oil, ghee  Orange, yellow and green fruits and vegetables (carrots, spinach, apricots, mango, pumpkin, broccoli).

This is a group of 8 water-soluble vitamins important for various metabolic processes. Each B vitamin performs a unique and separate func on in the body. B vitamins can be derived from different food sources and replenished daily through food. Most of these vitamins can’t be stored by the body and must be consumed regularly in the diet.

Func ons  Helps release energy from carbohydrates.  Needed for the proper working of the heart  Important for the growth and repair of ssues, especially the skin and eyes.  Helps in the synthesis of insulin  Important for diges ve health  forma on of fa y acids and cholesterol  produce new blood and nerve cells and DNA  Important for brain func on and immune system ·  Keeps the nervous system healthy Deficiencies  Fa gue  Restlessness, irritability,  Depression, moodiness, forge ulness.  Numbness and weakness of limbs  Burning sensa on in hands and feet.  Neurological disorders, nerve numbness and ngling.

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 Nausea, vomi ng, diges on problems,  Dry eyelids and eyes become sensi ve to bright sunlight.  The skin around the mouth becomes dry, with cracked lips, red and swollen tongue and sores/ulcers in the mouth.  Stomach pain,  Overall impaired growth  Anaemia Sources  Cereals, whole grains, wholemeal flour, parboiled rice,  Legumes, pulses, bran  Nuts, oil seeds, peanuts  Fish, lean meat, poultry, eggs,  Dairy products (milk, cheese, bu ermilk, Curd)  Vegetables, green leafy vegetables, peas  Soybeans,  Avocado

Vitamin C Vitamin C, also known as Ascorbic acid, is a water-soluble vitamin that is needed for healthy skin, gums, teeth, bones and car lage, assists in the absorp on of some types of iron, wound healing and resistance to infec on, strengthening blood vessel walls, improving the immune system.

Deficiency  Scurvy  Loose teeth, bleeding and swollen gums  Improper wound healing

Sources  Citrus fruit and juices, berries, Pineapple, Papaya, Amla, Guava  Capsicum, parsley, spinach, cabbage

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Cooking vegetables will reduce Vitamin C in substan al amounts.

Consuming raw salads and fruits is recommended.

Vitamin D Ge ng enough vitamin D helps the growth and development of bones and teeth in children. It helps to absorb calcium from food and regulate the amount of phosphate in the body which are needed to keep bones, teeth and muscles healthy. It may also provide improved resistance to certain diseases.

It is considered as Por- hormone, because it helps in necessary body processes and muscle movements.

Deficiency

Poor growth, bone deforma on, Rickets (deformed legs, knees circular, delayed teething, enlarged belly, thin legs and hand).

Sources  Sunlight  Fish, Liver, Egg yolk  Oils, milk fat

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Vitamin E Vitamin E is a vitamin that dissolves in Fat. It boosts the immune system and helps to maintain important func ons of the body.

Func ons  Improve blood vessel elas city  Improves Immunity.  Nourishes skin and hair Deficiency  Dry skin and hair.  Cardiac issues Sources: vegetable oil, fish, germina ng seeds, milk, eggs, meat

Vitamin K This vitamin is essen al for blood clo ng, which prevents excessive bleeding.

Deficiencies Leads to excessive bleeding a er Injury, Human babies do not have a reserve of Vitamin K and hence have to be injected with a dose at birth.

Sources  Green leafy vegetables, Broccoli and cauliflower, Eggs, Cheese, Wholemeal flour and bread

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MINERALS Minerals occur in natural foods, salt and water. They do not provide energy but play body func ons like managing blood pressure, maintaining haemoglobin, and maintaining bone strength.

Generals Func ons of minerals are:  Maintenance of balance of nutrients in body fluids.  Control of water balance.  Contrac on of Muscles.  Normal response of nerve to a physiological s mulus.  Clo ng of Blood.

Calcium The body only gets one chance to build strong bones, and that is during childhood and adolescence. If children can be provided enough calcium during these star ng years, they will have strong bones throughout their adult lives.

It will even protect them against bone loss later in life. Calcium also helps in nerve health, muscle contrac on and relaxa on, blood pressure, the immune system, and the release of hormones. Calcium is one nutrient that children can’t afford to skip.

The daily dietary allowance for children between 4-8 years is 1,000 mg/day and 1,300 mg/day for boys and girls of 9 to 13 years. Teens grow rapidly during adolescence with twenty percent of adult height and 50 % of the adult weight gained during this phase. Maximum of adult bone mass is also added during adolescence, hence the daily requirement of calcium increases to 1200-1500 mg.

See Annexure 2 Deficiencies  Muscle spasms and cramps  Weak teeth and delayed teething

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 Tooth decay  Numbness and ngling in the hands, feet, and face.  Weak and bri le nails.  Easy fracturing of the bones.

Sources

 Osteoporosis, especially in women, loss of stature, bent backs, high suscep bility to fractures of hip and wrist, and weak bones. headache, Inability to relax, depression, hallucina ons

 Milk and Dairy products (milk, cheese, curd and paneer ),  Whole grains, Til, Tofu and soyfor fied drinks, Almonds, eggs, fish, Ragi, and Amaranth are also rich sources.

Iron Iron is an essen al mineral found in almost all living organisms.  Without enough iron, the body won’t produce enough haemoglobin and red blood cells because of which the ssues and organs won’t get the oxygen they need to func on well.  Iron is needed for fetal brain development in the mother’s womb.

Deficiency of Iron  This deficiency can range from minor deficiencies to iron deficiency anemia.  Iron is required for normal blood development and low levels can contribute to feelings of redness due to anemia. Children with iron deficiency may experience difficul es in school, display problems with concentra on and a en on span.

Sources  Dark leafy vegetables  For fied breakfast cereals  Wholegrains  Legumes, Eggs  Lean red meat, poultry, seafood

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Iodine Iodine is an essen al nutrient for humans. It is important for growth and development but is required in very small amounts.

Iodine deficiency. This can cause the thyroid gland to work harder and increase in size. An enlarged thyroid gland, or goitre, can cause swallowing and breathing difficul es.

Sources- Seafood, Seaweed, Iodised salt Here is a list of other important minerals that growing children and teenagers requireMinerals Mineral Chromium

Func ons  Helps with normal growth  Plays a role in controlling blood sugar levels Deficiency can lead to difficulty in maintaining sugar levels in the body

Sources  Egg yolk  Liver and kidney  Lean meat  Wholegrains  Cheese

Copper

 Joins with iron in the forma on of red blood cells  Helps with the func oning of the nervous system.

Deficiency can lead to Fa gue, weakness, and anemia. some gene defects can also cause malabsorp on of copper  Helps with healthy bones and teeth  Decreases the chance of dental caries Deficiency affects the Enamel covering of teeth, Teeth bone becomes bri le

 Seafood like crab, lobster  Nuts  Yeast  Wholegrains

Fluorine / Fluoride

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 Fluoridated drinking water  Fish  Tea

Minerals Mineral Magnesium

Manganese

Phosphorus

Potassium

Func ons  Helps in making bones healthy  Involved in the release of energy from food  Essen al for muscle and nerve func on Deficiency results in weakness, muscle cramps, especially at night, heart arrhythmia  Helps in the forma on of healthy bones  Helps in the processing of carbohydrates, cholesterol and protein Deficiency leads to bone demineraliza on, poor growth in children  Works with calcium in the forma on of strong healthy bones and teeth  Helps the body to store and use energy Deficiency results in weak bones and teeth, bone pain and muscle weakness  Controls nerve impulses and muscle contrac ons  Helps maintain fluid balance Deficiency results in muscle weakness, abnormal heart rhythm, heart and respiratory failure

Sources  Milk  Whole grains  Green leafy vegetables  Legumes  Lean meats and fish  Nuts and seeds  Bananas  Nuts  Wholegrains  Cereals  Vegetables  Oils

 Meat  Milk and cheese  Eggs  Bran and wheat germ  Nuts and seeds

 Nuts, Dried fruit  Bananas  Bran and wheat germ  Raw fruit and vegetables  Lean meat and fish

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Minerals Mineral Sodium/Salt

Func ons  Controls nerve impulse transmission  Helps maintain water balance Deficiency can result in Irrita on, Seizures, Coma

Zinc

 Aids in wound healing and immune func on  Essen al for normal taste, smell and sight  Helps in the forma on of strong bones Deficiency leads to poor growth, Recurrent infec ons, Skin condi ons, Delayed wound healing, Cogni ve impairment

Sources Foods high in sodium are processed or commercial products:  Table, sea and vegetable salt  Sauces and stocks  Yeast extract,  Cheese  Bread  Lean meat, fish and chicken  Milk  Wholegrains  Legumes and nuts

See Annexure 3 for suggested food groups for balanced diet

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3

Chapter

Enhancing Nutri on

Food prepara on should include a wide range of food groups and a variety of cooking methods to retain maximum nutrients. This also creates varia on in flavour, texture, taste and presenta on. It helps to reduce and eliminate boredom and rejec on of repeated recipes. Over boiling, frying etc. while cooking can result in the loss of nutrients.

Home mothers will require consistent input in doing this through con nuous demonstra on especially using bulk cooking techniques.  ‘Single Dish Meals’ using broken wheat or rice and incorpora ng some

amount of a pulse or soya beans, a seasonal vegetable/green leafy vegetable, and some amount of edible oil will save both me and fuel besides being nutri ous. Cereal-pulse combina on is necessary to have good-quality protein. The

cereal dal ra o could range from 3:1 to 5:1. Sprouted pulses have more nutrients and should be incorporated in single-dish meals.  Recipes requiring fermenta on and sprouted pulses enhance nutri onal

value.  Cooking must be done with the lid on to avoid loss of nutrients and

contamina on.  Avoid overcooking food as it will reduce the nutri onal value of food.  Make Parathas of Palak, Methi, Cabbage, Lauki, coriander, Carrot, Beetroot.

To make it tasty and nutri ous and increase the protein, add ajwain, jeera, Sa u a a  Combining leafy vegetables with dal prepara on  Paratha must be had with raita or Chunda of raw mango, or cabbage

Pachadi  While making Suji upma – add Urad dal, Fresh green peas, finely chopped

beans and carrots, and peanuts. This will increase intake of vitamin A, calcium and fibre.

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 Rice

can be served accompanied by vegetables and proteins like Sambar, Rajmah, Chole, and dal of different types with added or accompanied veggies eggs curry, soya curry, and mushroom Curry.

 Palak soya Chunk Pulav, Green peas pulao with Raita, Pulses and vegetables

with Rice khichdi.  To include Millet in meals, make it in diges ble form -like Jawar, Bajara,

Ragi, and Kodo millet, these millets must be soaked in water for 6-8 hours, strained and dry for one to two hours and coarse grind in a mixer, roast it properly.  Make khichadi of these millets by adding vegetables, like onion, tomato,

corn, green peas, and carrots, to make them nutri on-rich.  In every Lunch try to include curd, and bu ermilk  Idli can do varia ons like mix millet idli with grated carrot, chopped beans,

or Mix millet Dhokla and uthappam with tomato chutney.  In milk instead of adding any protein supplement can add Chana Sa u and

dates and a banana milkshake. Potato, sweet potato, roasted or boiled can be used in a salad and it will

improve the nutri onal value of meals. Like carrot Poriyal  If Bhindi fry is made, you can add roasted chana a a, to make it crispy and

improve nutri on. Tomato and beetroot chutney can be added to meals.

See Annexure 4 for calorie value of cooked food

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4

Chapter

Other Essen als

Water Water is abundantly present in the body which is about 70%. It is found in the ssues, blood, and bones. Water is needed for most body func ons, such as:  It helps to maintain the hydra on of

each cell where energy is produced  Keeps the fluidity of blood and

the balance of proteins and other contents.  Helps to remove the waste products

of the body’s metabolism, excess electrolytes; sodium, potassium and urea, formed through the processing of dietary protein.  Regulates body temperature through

swea ng and respira on  Keeps the mucous membranes (such as those of the lungs and mouth)

moist.  Lubricates and cushions joints. ( if knees are knocking the chances are due

to low water intake)  Reducing the risk of urinary tract infec ons (UTIs), by keeping the bladder

clear of bacteria.  Helps diges on and absorp on of nutrients and prevents infec ons and

cons pa on.  Keeps the skin moist keeping it healthy.  Carries nutrients and oxygen to cells.

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The body needs fresh water every day because it can’t store water.

Recommended daily intake is two to three litres of water to eliminate toxins and infec ous bacteria.

Less water intake can impair cogni ve func on, and physical performance, and cause weakness, dryness, sunken eyes, s cky mouth, redness, muscle weakness, headache, cons pa on, dark brown or yellow urine and kidney infec on. Severe cases of dehydra on can be life-threatening.

Waterborne diseasesWater can act as an agent for transmission of waterborne diseases like bacteria, Viruses and protozoa. Waterborne diseases are a major cause of death in developing countries. These diseases can be transmi ed through contaminated water, poor sanita on, and poor hygienic condi ons. Climate change can also cause transmission of waterborne diseases. The most common diseases are diarrhoea, cholera, water-borne hepa s, dysentery, typhoid, E. Coli, and polio. Symptoms can include vomi ng, nausea, fever, cramps and loose mo ons.

Water must meet the required (Chemical, Biological and Physical) quality standards at the point of supply to the users. It is a defined level of quality that freshwater must meet to protect human health. In most urban areas, water purifica on technology removes contamina on from the source watergroundwater or surface water- before it gets distributed to homes, schools and other places. Some of the characteris cs of good quality water are:  Should be colourless and odourless  Should be transparent  Should be free from impuri es such as suspended solids  Should contain some minerals and salts necessary for our body and some

dissolved gasses to add taste  Should be free from harmful microorganisms

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Sleep Sleep affects children’s physical and mental growth and development.

Good sleep is a vital component for children to stay healthy. Children over 6 to 13 years need 9–12 hours while adolescents require 8–10 hours of sleep.  During sleep, the body’s energy is

restored and recharged wherein growth and repair occur.  During sleep, the brain is working.

It has a drainage system similar to the Kidneys, which removes toxins during sleep.  The right amount of sleep improves the release of growth hormones in

children.  Lack of sleep may lead to fat accumula on in the body leading to obesity as

a long-term effect.  Sleep loss can affect the child’s metabolic ac vity and energy balance.

Sleep depriva on causes fa gue during the day leading the child to become sedentary. Sleep loss can cause cravings for high-sugar and fat-rich food.

Sleep depriva on represses the immune system, and nega vely affects mood and behaviour.

Sleep impacts alertness, a en on, learning and memory - affec ng a child’s performance in school and overall learning.

Just like quality and quan ty of sleep contribute to how the body uses the nutri on entering it, food affects the quan ty & quality of sleep the child gets. A high-quality diet gives be er sleep. Be er sleep helps in be er growth (illustrate this).

Healthy sleep habits start in childhood Consistency or rou ne is key. Children should go to sleep on

wake up at approximately the same possible.

me and me every morning as much as

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 Consuming fruits, and vegetables regularly makes children sleep longer

and more deeply. Alterna vely, fast/junk food and highly processed foods are associated with shorter sleep dura on.  Ea ng very close to bed me may lead to sleep disturbance.  Excess liquids near or at bed me can result in waking up more frequently

at night.

Sunlight Sunlight—Sunlight is not only about warmth and brightness; it’s an essen al element in development of children. It helps the body to produce Vitamin D. That is why Its also called the ‘sunshine vitamin’. Children should be encouraged to play outdoors in the sun.

However, it is essen al to balance outdoor play with sun safety measures to protect them from harmful UV rays. Here are a few prac cal ps:  Morning sun is best. Avoid Exposure as the Sun peaks during the day  Avoid being in the sun for too long.

 Create par ally shaded play areas  Stay hydrated during outdoor play Physical Ac vity Good nutri on and plenty of exercise are the building blocks for strong growth and healthy development for children. Children need to be physically ac ve to achieve op mal growth as it balances the energy input and fosters op mal u liza on in the body.

Along with wholesome nutri on, physical ac vity helps in these ways:  In motor development, coordina on and movement skills.  Building and maintaining strong, healthy muscles, bones and joints  Prevents or delays the development of many chronic diseases.

Healthy heart, lungs and blood vessels, and prevent obesity.  Develop interpersonal skills through par cipa on in team sports.  Improves the quan ty and quality of sleep. Kids who exercise have greater self-esteem and be er self-images.

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Childhood is the right period to influence holis c children’s development.

Children need enough ac vity to balance the calories that they take in. Make me for physical play. Set aside at least sixty minutes every day for physical ac vity.

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5

Chapter

Healthy Prac ces

Hygiene and Sanita on  Waste disposal to ensure hygienic and mely discarding.  Sanita on of facili es like toilets and bathrooms to prevent contamina on

of water sources.  Avoid contamina on of potable water.  Cover water properly and keep away from ground level, and wash water

containers and utensils daily.  Water should be sent for lab check to detect contamina on  Frequent cleaning and maintenance of filters.

When the source of water does not ensure safe and pure water, the following methods can be used for purifica on: WHO does not recommend drinking RO water for long-term drinking due to its deficiency in essen al trace elements and minerals beneficial for the human body. However, consuming those minerals through food may reduce the adverse impact on RO water.

 Boiling - water for 10-15 minutes kills bacteria. However, chemical

pollutants are not removed. Filtra on - Water filters remove suspended par cles, parasites, bacteria,

algae, viruses and fungi.  Water purifier- cleans the water, and removes impuri es and bacteria that

cause diseases such as cholera, typhoid and diarrhoea. UV water purifiers are suitable for purifying municipal or tap water.

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 Reverse osmosis (R.O)- is a water purifica on technique that effec vely

eliminates dissolved salts, heavy metals, minerals, bacteria, viruses, and other harmful substances.

Food handlers’ hygiene  Wash and dry hands properly before handling food and wash and dry them

frequently during work.  Wash hands for 20 seconds with soap and warm water; wash the back of

hands, wrist, between the fingers, and under the fingernails.  Wash hands a er-

 Going to toilet  Handling raw food,  Blowing your nose,  Handling garbage,  Touching the nose, ear, mouth, or other parts of the body  Coming back from shopping  Dry hands with a clean towel. Wash and sundry kitchen towels frequently.  Do not smoke or chew gum, spit or eat in food handling and storage areas.  Never cough, or sneeze over food, or where food is prepared or stored  Wear clean clothes and a clean apron  Tie back or cover long hair.  Keep fingernails short, so they are easy to clean, do not wear nail polish.  Avoid wearing jewellery like rings, and bangles during food prepara on.  Keep extra clothes and other personal items like mobile, keys, bags away from food stored and prepared  Wear gloves if one has a wound.  Do not con nue working if you have nausea, vomi ng or diarrhoea. The symptoms should not persist for 48 hours before rejoining.

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Illnesses that are transmi ed through food and water include viral gastroenteri s, Hepa s A, and Hepa s E, sore throat with fever, and fever with Jaundice, Cold, flu, s es, and other eye infec ons.

Food Safety a) Storage of raw food:  Keep raw meat, poultry, seafood and eggs, away from other foods  Put Food in the fridge or Freezer, within 2 hours if it is 90 degrees or ho er outside  Thaw food a er taking out from the Freezer  Deep Clean Refrigerator regularly.  To Chill foods, the temperature should drop from 650 – 10 0C b) Cleaning raw foods:  Frequently wash the cu ng board, dishes, knives, and countertop with hot Soapy water.  The cereals and pulses should be cleaned thoroughly before cooking to remove unwanted ma er.  Leafy vegetables should be thoroughly washed before cu ng and should not be washed a er cu ng.  Soak & rinse fruits, and veggies with salt water before use  Do not wash Meat, Poultry, fish, or eggs with vegetables & fruits. If water splashes it can spread bacteria.  Wash the ns or packets of milk properly before opening c) Cooking Processes:  Use potable water for Food prepara on  Counter tops and surfaces in direct contact with raw food must be clean and dry before use.  Boil and cook non-veg properly to avoid under-cooked meat. d) Use and storage of cooked food  Cover cooked food properly.  Do not touch the food ready for serving.

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e) Post-cooking and food serving  Cleaning Utensils of food remains, rinsed, scrubbed with detergent and washed under running tap water a er use.  Separate and clean clothes/wipes for floors, surfaces of tables/ countertops and utensils.  Dust or crumbs from plates or utensils should be removed into a covered dustbin.  Cracks, rough surfaces, open joints etc. must be repaired without delay.  Holes, drain covers and other places where pests are likely to gain access should be sealed or fi ed with mesh/grills/claddings or any other suitable means as required and animals, birds and pets should not be allowed to enter the food storage and cooking area  Special a en on should be paid to the cleaning of obstructed sites including cooking areas and at the junc on of floors and walls  Wash kitchen towels, clothes, and sponges every few days.  Store all food and utensils at least 6 inches off the floor.

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Annexure 1 Here are a few op ons that are easy to prepare, cheap and tasty highprotein recipes.  Mixed sprouts chaat  Green pea chaat  Peanut Bhel  Moong dal chilla  Ragi pancake  Peanut chikki  Moong dal laddu  Sa u Paratha  Pongal  Dhokla  Mix sprout Idli,appam ,dosha  Sprout Bhel  Sprout and Jowar Khichdi,  Sprout and soya chunk cutlet  Egg burji  Besan Ladoos Annexure 2 Recommended Dietary Allowance of Nutrients for adolescents in 24 hours MALE FEMALE 10-12 Yr 13-15 Yr 16-18 Yr 10-12 Yr 13-15 Yr 16-18 Yr Energy (Kcal) 2200 2500 2700 2000 2100 2100 Protein (gms) 54 70 78 57 65 63 Calcium (Mg) 600 600 500 600 600 500 Iron (Mg) 34 41 50 19 28 30

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Annexure 3 Suggested Food Group for Balanced Diet to Meet Daily Nutrient Requirements Age

Group

1-3 yr

Body wt Cereals

Pulses

GLv

Vege

Roots Fruits

12.9

50

50

100

50

100

Milk

Fats

Eng

60-70 10

Nut

350

20

1110

38

Protein

4-6 yrs

18.3

160

60

50

100

50

75

15

350

20

1370

46

7-9

25.3

200

65

100

150

100

100

20

400

25

1710

59

10-12

Boys

34.9

280

90

100

200

100

100

30

400

35

2230

79

10-12

Girls

34.9

280

90

100

200

100

100

30

400

30

2060

70

13-15

Boys

50.5

390

130

100

200

100

100

40

400

45

2860

95

13-15

Girls

49.8

300

100

100

200

100

100

35

400

40

2410

81

16-18

Boys

64.4

450

150

100

200

100

150

50

400

55

3300

107

16-18

Girls

55.7

315

105

100

200W 100

150

40

400

40

2490

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Annexure 4 Approximate Calorific Value of Some Cooked Prepara ons Prepara ons Rice Phulka(without oil) Puri Paratha Bread Poha Upma Idli Dosa Khichadi Wheat Porridge Semolina porridge Pulses Plain Dal Sambar Vegetable with gravy Dry veg Eggs

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Quan ty per serving 1 cup 1 No 1No. 1No. 2 Slices 1 cup 1 Cup 2 No 1 No 1 cup 1 cup 1 cup

Calories (Kcal) 170 80 80 150 170 270 270 150 125 200 220 220

½ Cup 1 cup 1 cup 1 cup 1 no

100 110 170 150 90

Prepara ons Omele e Fried egg Mu on Curry Chicken Curry Fish fried Keema ko a curry Sweet Besan burfi Chikki Fruit Cake Rice Pu u Sandesh Double ka meetha Halwa Jam/Jelly Custard (caramel) Shrikhand Milk Chocolate Ice-Cream

Quan ty per serving 1no 1no ¾ cup ¾ Cup 2 big pieces ¾ cup (6 small kofta)

Calories (Kcal) 160 160 260 240 190 240

2 small pieces 2 pieces 1 piece ½ Cup 1 no ½ cup ½ cup 1 tbsp ½ cup ½ cup 25 gm ½ cup

400 290 270 280 140 280 320 20 160 380 140 200

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Notes

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Back Inner

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Nigh ngale Social Welfare Society Rainbow Homes Program H No: 1-3-183/40/21/51. Flat 202., K K Rao Residency, Gandhinagar Hyderabad-500080 Ph No. : 040-27660017 Website : www.rainbowhome.in