Clinical Reference Systems: Pediatric Advisor 10.0

HEALTH PROBLEMS RELATED TO DIET

At least six health problems have been proven to relate to diet:

1. Iron deficiency anemia

   The body needs iron to build red blood cells. This type of anemia usually occurs between 6 months and 2 years of age. It can also occur in adolescents, especially in girls with heavy menstrual periods. The main symptoms are fatigue, shortness of breath, and poor endurance.

2. Overweight

   Obesity is one of the most common nutritional problems in this country. Obesity is also one of the most important contributing factors in heart disease, hypertension, and some cancers.

3. Tooth decay

   Tooth decay is more likely if you have a lot of sugar in your diet. (Poor toothbrushing habits also contribute to tooth decay.)

4. Intestinal symptoms

   Too little fiber in the diet can cause intestinal problems such as constipation, abdominal discomfort, appendicitis, gallstones, and some intestinal cancers.

5. Coronary artery disease

   A lot of animal fat (especially cholesterol) in the diet contributes to coronary artery disease. This disease hardly exists in poor countries where the population subsists on low-fat, high-carbohydrate diets. It is also less common among vegetarians.

6. High blood pressure

   High blood pressure has been associated with an increased amount of salt or a decreased amount of calcium in the diet of some susceptible persons. Most people, however, get rid of extra salt through their kidneys and don't develop hypertension.

RECOMMENDATIONS FOR A HEALTHY DIET

1. Learn the four basic food groups:
   • milk products: milk, cheese, yogurt, and ice cream
   • meat/eggs: red meats, poultry, fish, and eggs
   • grains: breads, cereals, rice, pasta, and so forth
   • fruits/vegetables; may be consumed as solids or juices.

   Twenty percent of a healthy diet should consist of milk, meat, and eggs, and 80 percent should be vegetables, fruits, and grains. (Fiber is found in grains, fruits, and vegetables.) This is similar to the recommendations that people receive 55 percent of their calories from carbohydrates, 30 percent from fats, and 15 percent from proteins.

2. Eat three meals a day.

   Breakfast is essential. Skipping breakfast can compromise performance at school. For dieters, skipping breakfast usually doesn't lead to weight loss. All meals should contain fruits or vegetables, as well as grains. Meat or milk should be included in two of the meals.

   Eating snacks is largely a habit. Snacks are unnecessary for good nutrition but harmless unless you are overweight. If you like snacks, try to eat more fruits, vegetables, and grains.

3. Decrease the amount of fat (meat and milk products) in the diet.

   Americans eat excessive amounts of meat and dairy products.

   To decrease the amount of fat in the diet, follow these guidelines:

   • Remember that one serving of meat per day is adequate for normal growth and development. (Don't eat meat more than twice a day.)
   • Eat more fish and poultry and fewer red meats, since the latter have the highest cholesterol levels. Lean red meats are lean ground beef, pork loin, veal, and lamb.
   • Trim fat off meats and the skin from poultry.
   • Don't eat bacon, sausages, spareribs, pastrami, and other meats that have a high fat content. Cut back on hot dogs, lunchmeats, and corned beef.
   • Limit the number of eggs to 3 or 4 per week. (Eggs have the highest cholesterol content of any of the commonly eaten foods. The cholesterol in one egg is equivalent to the cholesterol in 14 ounces of beef, 1-and-1/2 quarts of whole milk, or 1 quart of ice cream.)
   • Drink 1- or 2-percent milk instead of whole milk.
   • Decrease the amount of milk you drink to 2 or 3 cups per day. (Drink water to satisfy thirst.)

     On the other hand, some teenage girls may need to be reminded to consume adequate milk products (the equivalent of 3 glasses of milk) to lay down the bone mass required to prevent osteoporosis later in life.

   • Eat margarine instead of butter.
   • Keep in mind that red meat may be hard to give up because of the widespread misconception that red meat helps to build muscle mass and strength.

4. Increase the amount of fruits, vegetables, and grains in your diet.

   Follow these guidelines:

   • Consume at least five servings of fruits and vegetables per day. (Fifty percent of Americans eat only one fruit or vegetable per day.)
   • Try to eat a fruit at every meal.
   • Eat more fruits as dessert and snacks.
   • Start every day with a glass of fruit juice. (Caution: limit fruit juices to 2 cups per day to prevent diarrhea.)
   • Since fruits and vegetables are interchangeable, you don't have to eat vegetables you don't like.
   • Eat more soups.
   • Eat more cereals for breakfast.
   • Use more whole-grain bread in making sandwiches.

5. Include an adequate amount of iron in the diet.

   Throughout our lives we need adequate iron in our diets to prevent anemia. Everyone should know which foods are good sources of iron. Red meats, fish, and poultry are best. One serving per day of these foods will provide adequate iron. Although liver is a good source of iron, it contains 16 times more cholesterol than beef and should be avoided. Adequate iron is also found in iron-enriched cereals, beans of all types, peanut butter, raisins, prune juice, sweet potatoes, spinach, and egg yolks. The iron in these foods is better absorbed if the meal also contains fruit juice or meat.

6. Avoid excessive salt.

   Salt is not usually harmful for people without high blood pressure. However, to discourage a taste for excessive salt, remove the salt shaker from the dinner table. Use other herbs and spices instead of salt. Eat salty foods such as potato chips and pretzels sparingly.

7. Avoid excessive pure sugars.

   Sweets are not bad, but they should be eaten in moderation. Most humans are born with a "sweet tooth." They seek out and enjoy candy, soft drinks, and desserts. The main side effect of eating candy is tooth decay if the teeth are not brushed afterward. Eating food with a lot of sugar ("a sugar binge") can cause, 2 or 3 hours later, jitters, sweating, dizziness, sleepiness, and intense hunger. This temporary reaction is not harmful and can be relieved by eating some food. A love of sweets is not related to obesity (if the total calories per day are normal) or hyperactivity. A high amount of sugar in the diet has not been correlated with coronary artery disease or cancer.

8. Know what to eat before exercise.

   Eating meat does not improve athletic performance. The best foods to consume before prolonged exercise are complex carbohydrates (starches). These include bread, pasta (noodles), potatoes, and rice. These should be consumed 3 to 4 hours before the athletic event so they have passed out of the stomach.

   Water consumption continues to be important up to the time of participation and every 20 to 30 minutes during the activity.