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Breakout Session III—Nutrition
and Physical Activity Issues for Infants, Children, and Adolescents
Moderator: Kevin Patrick
Speakers: William C.
Heird, Ruth A. Lawrence, Mary Cogswell, Vicky Newman, and James
Sallis
Recorders: Kristen Biskeboon,
Carolyn Sharbaugh, Judy Selberg
Purpose: The importance
of nutrition during infancy, childhood, and adolescence is paramount.
There are critical stages in development when nutritional factors,
as well as opportunities for physical activity, are likely to have
long-term health consequences in adulthood. Interventions must consider
the physiological, behavioral, and social aspects of each developmental
stage.
Topics—Summary and Recommendations
What role does nutrition play
in the care and management of low-birth-weight infants? Are there
long-term consequences?
William C. Heird, Baylor College of Medicine
Increased survival of low-birth-weight (LBW) infants
has created new issues related to the long-term effects of this
status on their health. While there are many solutions to the problem,
ranging from reducing the incidence of LBW infants to improving
strategies for "catch-up" growth, perhaps the most important is
to optimize the early nutritional management of LBW infants. A key
research question in this area relates to what percent of improved
outcomes in LBW infants will ultimately be attributable to improved
nutritional management.
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Human milk provides more than
nutrition. What strategies are needed to increase the proportion
of women who breastfeed for at least 6 months?
Ruth A. Lawrence, University of Rochester
School of Medicine
The overarching issue is how to increase the number
of women who breastfeed their infants for at least 6 months. It
is essential that this become viewed as normal behavior if we are
to achieve the full health benefits that can be derived from human
milk. Recommendations to reach this goal must, by necessity, be
multifaceted and involve both the public and private sectors. Successful
strategies will include educational interventions for children in
schools and in clinical settings for new mothers. Supportive work
environments are required, including longer paid maternity leave
and adequate at-work nursing facilities. Finally, serious consideration
should be given to direct monetary rewards to women as incentives
to breastfeeding.
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Declines in iron deficiency
among low-income toddlers: What more can we do? Should we be concerned
about other micronutrients?
Mary Cogswell, Centers for Disease Control
and Prevention
There has been excellent progress in addressing the
problem of iron deficiency in children in the United States. This
is in large measure due to the WIC program. However, there are still
disparities that need to be addressed based upon socioeconomic status,
racial characteristics, and other factors. We must increase our
understanding of the biological mechanisms of the impact of mild
to moderate iron deficiency on motor, mental, and behavioral development
in children. As well, we must develop new knowledge about the negative
consequences that deficiencies in other micronutrients (e.g., zinc,
iodine, calcium, vitamin D) might have on normal growth and development.
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The heterogeneity of nutrition
issues in adolescents (e.g., iron deficiency, calcium intake, obesity,
eating disorders) presents a particularly difficult challenge for
the design and execution of targeted interventions. How effective
are existing programs?
Vicky Newman, University of California
at San Diego
A deep concern exists about the deterioration of environmental
cues and food choices for adolescents in schools and communities.
In many school settings, commercial and financial considerations
play too large a role in the types of food available and/or its
cost. In community settings and the media, adolescents are the prime
target for marketing such "foods" as empty-calorie sodas and junk
food. There is a need to find better ways in which we can improve
vegetable and fruit intake in adolescents. In particular, the focus
of this research should be on increasing fruits and vegetables rich
in vitamins A and C and folate.
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What is the developmental significance
of physical activity? What are health outcomes during youth? Does
physical activity in youth predict health or activity outcomes during
adulthood? What are the intervention opportunities in youth?
James Sallis, San Diego State University
Improved nutrition and physical activity are correlated
and have joint beneficial effects on many short-term and long-term
health issues for youth. Together, they also improve academic performance.
Unfortunately, there has been a substantial decline in levels of
physical activity and an increase in obesity in youth since the
first conference on nutrition 30 years ago. While we have some programs
that are known to be effective in promoting physical activity in
schools, we need to find ways to improve their adoption. Further
research is needed to explore ways in which we can design opportunities
for safe and healthy physical activity for youth in our communities.
Finally, we must explore ways to stem the tide of sedentary activity
associated with excessive media-related activity (e.g., TV, computers).
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Final Overall Issues and Questions
- More basic nutrition research is needed to elucidate
the theories and discover the biological mechanisms involved when
nutritional deficiencies hinder optimal growth and development.
Some of this research may take decades to accomplish, given that
manifestations of these deficiencies may develop only over a long
period of time.
- An appropriate balance must be struck between funding
for food assistance programs and funding for basic nutritional
research.
- Do we need to limit "imitation" foods given to
children? Or food additives? Or supplements? Much more needs to
be known about the short- and long-term effects of these substances
on healthy growth and development.
- There needs to be a collaborative, interagency
cooperation in partnership with industry and trade associations
to address the many issues raised at this conference. The Food
Safety Initiative is a good example of this.
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