IMPROVING THE NUTRITION OF THE NIGERIAN CHILD THROUGH DIETARY MODIFICATIONS

Professor Adenike Addo Department of Nutrition and Dietetics, University of Agriculture, Abeokuta Ogun State, Nigeria.

INTRODUCTION
Who is a child? Population of Nigerian children National and International agreements on the right of the child. Hunger, protein energy malnutrition and micronutrient deficiency constitutes denial of the rights of the children Socio economic cost of malnutrition

To examine the state of global child nutrition To examine the nutrition and food consumption of the Nigerian child To identify the causes of malnutrition To appraise the role of change agents in improving child nutrition To propose dietary modifications for improved child nutrition To project the importance of dairy foods in the diet of children . e. f. b. d.Objectives of the paper a. c.

The high level of stunting in developing countries indicate chronic hunger. Table one . stunting and underweight.State of world child nutrition Under nutrition in children is a global phenomenon which is characterized by wasting.

1 12.3 25.7 24.7 40.0 7.Table 1: national wasting.0 0.1 25.4 21.1 .8 0.8 0.5 5.5 0. stunting and underweight in pre-school children 0-5 yrs Country Year of survey Wasting % Stunting Underweight Ghana Iraq Kenya Mauritania Netherlands Niger Nigeria Nigeria Peru Togo 1998-99 2000 1998 2000-2001 1980 2000 1999 2001-2003 2000 1998 9.1 31.0 34.9 22.7 33.1 30.5 42.6 15.9 12.9 6.7 25.7 13.6 9.1 33.0 25.9 22.9 15.8 39.

Table 2 Table 3 Figure 1 The high level of under nutrition in the world demands that human and material resources must be mobilized at all level to solve the problem . iodine and iron also exist globally. Africa rather than Asia now has more underweight preschoolers Micronutrient deficiencies in vitamin A.State of world child nutrition A shift in level of global malnutrition has been reported in the last decade.

1 3 3 .2 12664 S o uth a nd E a s t A s ia 169.4 0 6 E a s te rn M e d i te rr a n e a n 59818 2 1 .3 8 .0 55.9 3 4 3 2 . 812 W e s te r n P a c i fi c 122. 006 1 4 .5 45 S o u rc e : S C N 5 th re p o r t o n t h e w o r ld n u tri ti o n s i t u a ti o n .2 1 8 E u ro p e 152 2 9 . 009 3 3 .0 17128 R e g io n o f the A m e ri c a 4 7 .5 7 5 1 7 .Table 2: Global prevalence of pre school child vitamin A deficiency T a b le 2 : G lo b a l p r e v a le n c e o f p r e s c h o o l c h ild v ita m in A d e f ic ie n c y R e g io n P o p u la ti o n < 5 ye a r s % No of cases (X 1 0 3 ) A fri c a 1 0 3 .

0 66.2 1239.6 19.4 Total number millions 59.8 2.Table 3: Prevalence of iodine deficiency in school age children Iodine deficiency (UI < 100 ug/L) Region General % Population Total number million 342.7 7.3 330.7 38.5 Source:SCN 5th report on the world nutrition situation.1 10.3 69.4 13.2 9.1 1.2 27.7 10.0 26.7 187.6 52.8 47.5 64.1 Africa Asia Europe Latin America & Caribbean Caribbean North America Oceania 43.0 35. .8 9.3 53.7 2.2 School age children % 42.5 59.

2003 70 60 50 40 30 Percent 20 10 0 Africa Americas South East Asia Europe Eastern Mediterranean Western Pacific .Figure 1: Prevalence of anaemia in children 0-5 years by WHO region 1998 Source: Food Consumption and Nutrition Survey 2001 .

Nutrition and food consumption of the Nigerian child Protein calorie malnutrition's continues to be the most important problem of under nutrition in the Nigerian child Most recent national survey (2001-2003) show that 42% of preschool children were stunted. 25% were underweight and 9% were wasted. Figure 3 Figure 4 . (table 1) Figure 2 Varying levels of micronutrient deficiencies were also reported.

Figure 2: Stunting.2003 45 40 35 30 25 20 15 10 5 0 Stunting Wasting Underweight Percent . wasting and underweight Source: Food Consumption and Nutrition Survey 2001 .

2003 80 71.8 4.7 Marginal Clinical .5 70 60 50 40 Percent 30 20 10 0 Normal 24.Figure 3: Vitamin A status of all surveyed children under 5 Source: Food Consumption and Nutrition Survey 2001 .

2003 60 50 40 30 Percent 20 10 0 Iron deficiency (< 10 ng/ml) Iron store depletion (< 20 ng/ml) Normal (range 20 100ng/ml) Above normal range (101 300 ng/ml) Iron overload (> 300 ng/ml) .Figure 4: Profile of national iron status in all surveyed kids under 5 Source: Food Consumption and Nutrition Survey 2001 .

Causes of malnutrition Figure 5 UNICEF framework for causes of malnutrition helps to interprete observations on malnutrition The immediate and underlying causes of malnutrition are a reflection of the denial of the rights of the child. . The 2001-2003 national survey established association between food security. child care and health and nutritional status of preschool children.

economic.Figure 5: Causes of child under nutrition Figure 5: Causes of child undernutrition BASIC CAUSES IN SOCIETY Quantity and quality of actual resources— human. Oxford: Oxford University . people Source: UNICEF (1998) The State of the World’s Children 1998. and organizational—and way they are controlled Political. cultural. religious. economic. technology. and social systems. limit the use of potential resources Potential resource s: environment. including status of women.

and disability IMMEDIATE CAUSES Inadequate Dietary intake Disease UNDERLYING CAUSES AT HOUSEHOLD/FAMILY LEVEL Insufficient access to FOOD Inadequate maternal and child CARING practices Poor water/ sanitation and inadequate HEALTH services Inadequate and/or inappropriate knowledge and discriminatory attitudes limit household access to actual resources . death.OUTCOMES Child undernutrition.

Household level. the role of mothers. Implementation strategies to improve food security. UNICEF. Educational institutions – role of primary school teachers Health Care Givers Food industries . UNDP Development or nutrition goals 1990 Millennium Development Goals with nutrition as indicators (Goals 1-6) National level National Policy on Food and Nutrition in Nigeria.The role of change agents in improving child nutrition. women education. ILO. child care and health. International level – United Nations through its organ of WHO.

oils & s ugar E nergy 2 s ervi ngs M ilk and M ilk pro duc ts P rotein M eat. s pinac h. tom ato es . gam es . ac ha. etc 2 s ervi ngs Roots an d tube rs e. eggs Gre en a nd y ello w veget ables e.g. m illet. ba m ba ra n uts . potatoes . wheat. c oc oy am . lem ons . c as s ava an d c as s a va p ro duc ts E ner gy E ner gy P rotein. gree n pe as . fis h. paw pa w. m an go es . V itam ins Fat 4 s er vi ngs M aiz e. pep pe rs 2 s ervi ngs 3 s ervi ngs M iner als and vitam ins 2 s er vi ngs Fruits e. pine ap ples . bana nas . gr oun dn uts . beans . ric e. ora ng es . pig eon peas .g. guin ea c or n.g. y am s . s oy abea n . poultry .Figure 6: Food pyramid Us e s pari ngly Fats .

. ensure variety in the diet.Dietary modification for improved child nutrition Food habits of children Nutrient requirements of children Table 4 Modification of diet using Food Based guidelines Food Pyramid. Whatever method.

4 1360 5.4 60 0. 5 5-10 4-6 20.2 1830 7.0 0.1 12. 5 5-10 7-9 28.0 0. 5 5-10 a As egg or milk protein b As retinol .4-0.1 2190 9.3 0.5 100 1.7 16 250 10.4-0.5 0.5 5.5 20 0.1 100 1.0 0.4 14 300 10.Calcium B12 bic acid (g) (mg) (µg) Iron (mg) Children <1 7.8 9.5-0.5 20 0.4-0.7 1.0 100 0.3 820 3.6 20 300 10.3 14.9 20 0.3 20 0.9 1.2 25 400 2.Table 4: World Health Organization Recommended Intakes Age Body Weight (kg) Energy (Kcal) (MJ) Proteina (g) Vitamin Vitamin Thiamin RiboflaAb Dc (mg) vin (mg) (µg) (µg) Niacin (mg) Folic acid (µg) Vitamin Ascor.5 0. 6 5-10 1-3 13.

Nutrient content of milk Table 5 Constraints to milk drinking behaviour in children i. Milk not a school feeding programmes iii. Parents do not drink enough milk to influence their children's milk drinking behaviour.Importance of dairy foods in the diet of children Milk provides protein for growth and calcium for skeletal bone mass. . availability of soft drinks and other competing beverages ii. The flavour of milk iv.

8 280 250 Phosphorus mg Iron mg 1. Milk.7 100.1 8.5 3.Table 5: Nutrient Composition of milk and milk products (per 100 grams edible portion) Moisture % 1. canned.8 3.0 1.1 10.2 3.8 112 132. Nono 3. Ice .1 94.8 45.0 123.3 .6 1.0 14.1 0.8 359. Yoghurt 70 90 90 KJ Protein g 12.7 352.cream 8. Milk (Fluid whole evaporated) 4. Milk. Chocolate milk 7.4 24.6 5. Cheese (local while ware) 2. sweetened condensed 6.0 11.8 9.6 Fat g 15.24 0.5 38.0 325 298 172 255 0.0 Calcium mg 95 6.0 3.7 0. skim 5.3 0.0 Carbohydrate g 0 2.3 120.2 345 300 32.0 110 327 8.1 259.1 104 406.5 3.1 4.2 10.0 8.2 0.4 100.8 0.0 56.5 Vitamin A IU 370 610 798 188 660 79 9.0 9.

Dietary modification with improvement in milk consumption would improve child nutrition .Conclusion Existence of child malnutrition in Nigeria due mainly to poor feeding habits child care and health.

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