Nutrient Intake and Deficiencies
Nutrient deficiencies are common in children. Children of poor families are more obviously at risk of malnutrition. Children of more affluent families may also suffer malnutrition in the form of wrong food choices caloric excess, nutrient disproportion and even vitamin and mineral deficiencies when packaged and processed food replaces real food
Concern for nutritional deficiencies in children has led to routine vitamin supplementation of staple foods: breads, breakfast cereals and fruit juices. Vitamins D, C, thiamin, and riboflavin are added to these foods as supplements. Concern for iron deficiency in children led to the widely debated recommendation to supplement flour with iron. Iron has been added to infant cereals to cover the deficient period from six months onward. Folic acid is the most recent food additive – now added to wheat flour in the USA and Canada to prevent neural tube birth defects. In Canada, folic acid has been added to flour and the government has initiated a major public education campaign to recommend folic acid supplements to women who are likely to become pregnant. Canadian effort to increase folic acid intake has been successful in reducing the incidence of neural tube defects during fetal development. [i] Vidia Persad and coauthors showed a reduction of 54% in the total incidence of live births, stillbirths and terminated pregnancies after 3 years of folic acid food fortification in Nova Scotia.
Skinner et al assessed the nutrient intake of children to 24 to 60 months old. They stated: ”Parents need to be encouraged to include more sources of zinc, folate, vitamin E, and vitamin D in children's diets. Parents should also encourage their children to eat more vegetables.”
Johnson et al reported on a US study showing a widespread nutrient deficiency in adolescents. They stated: “Adolescents consumed diets that were low in several essential vitamins and minerals and high in some nutrients related to increased incidence of chronic disease. Vitamin A, vitamin E, calcium, magnesium, and zinc were the nutrients consumed below recommended levels. In addition, females consumed low levels of phosphorus and iron. Percent calories from total fat and saturated fat and mean sodium intakes were above recommended.“ (see abstract)
One assumption of national food fortification programs is that all children will eat the manufactured, fortified foods. There are good reasons for some children not to eat these foods and they require personal supplementation with vitamins and minerals. Parents who modify their child’s diet will need to aware that some professionals are dogmatic and irrational about nutrient intake. With any mention of elimination of wheat or dairy products from the child’s diet, for example, these irrational folk make accusations of depriving the child of essential nutrients. Some of these dogmatic people are in positions of authority, so be prepared to avoid them. In the Alpha Nutrition Program, it is assumed that all children will receive an excellent choice of nutrient-rich foods and in addition, will receive nutrient supplements so that there is no question of nutrient deficiency.
[i] Rezan A. Kadir and Demetrios L. Economides Neural tube defects and periconceptional folic acid CMAJ • August 6, 2002; 167 (3)