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

b. d. 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 . c.Objectives of the paper a. f. e.

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

9 22.6 15.Table 1: national wasting.7 40.6 9.1 30.7 13.4 21.9 22.1 33.0 7.5 5.7 33.9 12.8 39.1 12.7 24.1 .3 25.1 31.1 25.8 0.9 6.0 25.0 34.5 42.7 25.8 0.0 0.9 15. 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 9.5 0.

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. 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 .

812 W e s te r n P a c i fi c 122.5 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 .4 0 6 E a s te rn M e d i te rr a n e a n 59818 2 1 .0 55.3 8 . 006 1 4 .1 3 3 .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 .2 12664 S o uth a nd E a s t A s ia 169. 009 3 3 .5 7 5 1 7 .9 3 4 3 2 .0 17128 R e g io n o f the A m e ri c a 4 7 .2 1 8 E u ro p e 152 2 9 .

4 Total number millions 59.8 47.7 10.3 53. .1 Africa Asia Europe Latin America & Caribbean Caribbean North America Oceania 43.2 School age children % 42.6 52.8 9.2 1239.3 69.7 2.2 9.1 1.5 59.2 27.4 13.0 26.3 330.5 Source:SCN 5th report on the world nutrition situation.7 38.7 187.8 2.7 7.1 10.5 64.6 19.0 66.Table 3: Prevalence of iodine deficiency in school age children Iodine deficiency (UI < 100 ug/L) Region General % Population Total number million 342.0 35.

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 .

(table 1) Figure 2 Varying levels of micronutrient deficiencies were also reported. 25% were underweight and 9% were wasted. Figure 3 Figure 4 .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.

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 .

5 70 60 50 40 Percent 30 20 10 0 Normal 24.2003 80 71.Figure 3: Vitamin A status of all surveyed children under 5 Source: Food Consumption and Nutrition Survey 2001 .7 Marginal Clinical .8 4.

Figure 4: Profile of national iron status in all surveyed kids 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) .

child care and health and nutritional status of preschool children. The 2001-2003 national survey established association between food security.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. .

including status of women. Oxford: Oxford University . technology. religious. and social systems. cultural. people Source: UNICEF (1998) The State of the World’s Children 1998. 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. and organizational—and way they are controlled Political. limit the use of potential resources Potential resource s: environment. economic.

death.OUTCOMES Child undernutrition. 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 .

child care and health. Implementation strategies to improve food security. 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 mothers.The role of change agents in improving child nutrition. Educational institutions – role of primary school teachers Health Care Givers Food industries . International level – United Nations through its organ of WHO. UNICEF. women education. ILO. Household level.

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

.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. ensure variety in the diet. Whatever method.

8 9.0 0.7 1.5 5. 5 5-10 7-9 28.5 0.2 25 400 2.1 100 1.1 2190 9.3 0.2 1830 7.3 20 0. 5 5-10 a As egg or milk protein b As retinol .5 20 0.5 0.5 100 1.0 0. 5 5-10 4-6 20.9 1.1 12.3 820 3.Calcium B12 bic acid (g) (mg) (µg) Iron (mg) Children <1 7.9 20 0. 6 5-10 1-3 13.5-0.4-0.7 16 250 10.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.4-0.5 20 0.3 14.4 60 0.6 20 300 10.4 14 300 10.4-0.0 0.4 1360 5.0 100 0.

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

4 24.2 3.5 Vitamin A IU 370 610 798 188 660 79 9. Milk.4 100.Table 5: Nutrient Composition of milk and milk products (per 100 grams edible portion) Moisture % 1. skim 5.1 8.2 0.2 10. Cheese (local while ware) 2.3 120. Milk (Fluid whole evaporated) 4.7 0.5 38.1 10. sweetened condensed 6.6 1.8 280 250 Phosphorus mg Iron mg 1.8 359.0 14.24 0.cream 8. Chocolate milk 7.0 325 298 172 255 0.0 Carbohydrate g 0 2.6 5. canned.0 110 327 8.3 .1 0.0 11.8 45.0 56. Nono 3.8 112 132.8 0.0 123.0 9.2 345 300 32.1 4. Ice .8 3.8 9.7 100.0 3.1 94.0 1.3 0.5 3.7 352.1 259.6 Fat g 15.0 Calcium mg 95 6. Milk. Yoghurt 70 90 90 KJ Protein g 12.5 3.1 104 406.0 8.

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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