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Iron deficiency or anaemia is the most common nutritional deficiency found in India. Most children do not like green vegetables, which are rich in iron. Iron-deficient blood does not carry a normal oxygen load and may contribute to reading disability, poor attention in class, reduced activity and learning ability. It is a known fact that lack of proper nutrition, especially during the first two years of life, can lower the intelligence of the child and consequently affect his behaviour. Undernourished children are less attentive, lack motivation and concentration. However these symptoms need not be only due to malnutrition, as it is difficult to separate direct effects of malnutrition on the brain from the other circumstantial factors which bring about the same symptoms. Lack of proper nutrition is a significant non-genetic factor, which influences the development of the brain in young children. Obesity in children Studies show that every one child out of two is obese amongst the urban, upper-income group. Excess weight may have psychological consequences that may affect the child in many ways. One of the major factors influencing the diet of children aged between five and 18 years is the television commercials. These urge the youngsters to eat high-sugar foods like ice creams, noodles, chocolates, cookies, ketchups rich in refined flour (maida), fat and sugar. These foods have negligible nutritional value. When consumed in between meals, these provide unnecessary calories and the child, then, refuses to eat his meals. When this pattern of eating low-nutrition, commercially advertised foods is practised over a period of two to four months, nutritional deficiency sets in along with obesity. Healthy family attitude and fitness routines, including walks and encouraging sports, can do much to minimise obesity in children. Parents should act as role models for children and practice eating healthy and adopt physically active lives. They should also ensure that the child engages in vigorous physical activity on a year-round basis. Colas and chocolates are popular amongst most children. Studies show that children who consume more colas and chocolates were rated to be 'hyper' as compared to those who consumed less colas and chocolates. Children who eat junk food have reduced immunity and fall sick more frequently. Poor nutrition thus caused reduces the body's capacity to resist disease and infections. Smart snacking
Fruits and vegetables: Eating fruits and vegetables is habit forming. If you cultivate a habit in your child to snack on fruits he/ she would seldom enjoy other sugar-based snacks. This habit has to be cultivated from the age of 3-4 years onwards. Nuts: Nuts like peanuts and almonds (much needed by growing children) are rich in proteins and vitamin E. These provide a healthy snack and are easily accepted by most children. Sprouts: Most whole grain pulses like whole green moong, chana, rajmah, soya bean, black whole urad can be sprouted and used to make bhel chaat. Add these sprouts to the regular dry bhel with kurmura (puffed rice) and peanuts, chopped onions and sprouts with limejuice and salt to taste. Yogurt or curd: It is not only a handy breakfast or snack but also one of the most versatile foods to use in cooking. Nutritionally, low-fat yogurt is a winner. Being rich in calcium, protein, not too much of fat, and moderate amounts of zinc, yogurt can be easily tolerated by both children and adults. Yogurt can be eaten either plain or as a dip or a dressing. If you hang it in a straining cloth overnight in the refrigerator, what is left in the strainer is yogurt cheese, which can be used as a dip with garlic and mustard. Corn: Most children like corn on the cob (bhutta). It is a respectable source of zinc and iron and low in sodium. Its protein quality is good. Cottage cheese (paneer): It is a good source of protein and calcium for growing children. It is low in fat and makes a good snack. Add as thick layer in sandwiches along with tomato puree or in a vegetable roll. Pass through a sieve, press with the back of the spoon and flavour with mustard, salt, pepper and use as a dip. Marinate with curd or salt and lime juice and grill in the oven. Tofu: Known as soya-bean curd, tofu has plenty of protein about 9 gm per 2 inch square piece. It is very low in calories less than 100 cal in a 2-inch piece. It is loaded with calcium and iron and has virtually no sodium. Tofu is low in saturated fat and is therefore heart friendly. It can be added in clear vegetable soups, used in sandwiches either as a paste with tomato puree or as a layer. Or cook it with soya sauce, ginger, garlic and mushroom. Healthy snacks as mentioned above should be readily available at home especially after school, so that the child's appetite for dinner will not get blunted by a late evening snack. Sugary foods like pastries and chocolates should be avoided in lunch boxes. Such foods, in addition to being high in calories and low in other nutrients, also increase the risk of dental caries. However, occasionally when such snacks are eaten, children should be urged to rinse their mouths with water. As a parent, one of the most important gifts you can give your child is a wise way of eating. It will not only help his brain to develop to its full potential, but it will also make his body grow proportionately. If you want a bright future for your child, begin by focusing on his eating habits first. Tips for parents and teachers
* Teachers should work with parents and school authorities to remove soft drinks, coloured ice creams and coloured boiled sweets, chocolates and other caffeine beverages from school cafeterias. These should be replaced with fruits, nuts, fruit juices and milk-based drinks, whole wheat vegetable sandwiches, vegetable rolls, etc. Parents and teachers should ensure that healthy food is available in school canteens. * Parents and schools should adopt practices that limit foods high in sugar, salt, calories, trans-fats and saturated fats and encourage eating fruits and vegetables, whole grains and pulses. * Schools should ensure at least 30 minutes of aerobic physical activity for all students every day. — The writer is a nutritionist. She treats obesity and related health disorders online. She can be reached at
ask@health-total.com / www.health-total.co
For perfect pearlies
Early Childhood Caries (ECC) Early childhood caries is often a development of severe tooth decay in infants and young children. Food accumulated on teeth in presence of oral bacteria, is a source of acid production which leads to tooth decay. It is a rapidly spreading decay that initially affects the four upper teeth followed by the posterior teeth. The decay typically starts as a dull white band on the smooth surface of the tooth at the gum line, followed by yellow discoloration. As the condition advances, a soft brown or black collar surrounds the tooth, progressing slowly towards the chewing surface of the tooth. Eventually the tooth breaks off, leaving only a decayed stump where once a healthy tooth was. The pattern described above is typical but different conditions may reveal different clinical patterns. It is important to treat milk teeth The primary teeth are very important and contribute to a child's overall development. Dental decay in primary teeth is an infectious process that can be quite painful, spread and affect the overall health of child. Pain interferes with the normal routine activities of child. Disturbed sleep at night further lowers the productivity of child in school. Healthy primary teeth are important for proper chewing which helps assure proper nutrition. Also these teeth hold the space in the dental arch until the permanent teeth are ready to appear, thus aiding in overall facial development. It has been observed that children who have decayed teeth have problem with proper development of speech especially alphabets like t, d, s. More over dental decay in baby teeth often means that there will be decay in permanent teeth. How to prevent ECC Parents can contribute to the oral health of the child right from birth. Good oral practice among parents is the foremost in inculcating good health attitudes in children. At their level, mothers should avoid sharing of foods and utensils as this facilitates transmission of cariogenic (promoting the development of tooth decay) bacteria thus increasing the bacterial load in children. Subsequently, when eruption begins, teeth provide an ideal environment for these bacteria to perpetuate. Presence of increased microbial load, combined with wrong feeding habits provides a regular substrate for bacteria and starts a vicious cycle which leads to tooth decay. Mothers should avoid night time feeding in children after six months of age as milk stagnates in the oral cavity during sleep leading to decay. After every feed child's oral cavity should be cleared with plain water or a moist cloth. The mother should wrap a clean moist cloth around her finger and wipe over the gum pads. Don't use a bottle to put an infant to bed. Use a favourite blanket, toy or a clean pacifier. If a child must be pacified or put to bed with a bottle, give a bottle filled with plain water. Initially, if a child does not adapt to plain water, it may be necessary to fill the bottle with a mixture of milk and water, then keep on reducing the amount of milk slightly each time until it is filled with water only. A child should be encouraged to start using a cup as soon as he/she can sit up unassisted. Parents should encourage their child make a transition from bottle to cup by 12 months. Further, parents can be guided about more tooth friendly and healthy diets which should include cheese, nuts, etc during snack hours instead of chips and breads which tend to accumulate on teeth leading to decay. Brush away troubles Also night time brushing should be encouraged. Parents should supervise as a child lacks sufficient dexterity to perform proper cleaning. Toothbrushes should be changed at first sign of matting. Matted tooth brushes have greater surface area that harbours increased bacterial load along with reduced cleaning ability. Ideally tooth brushes should be changed every three months. Ideally, the first visit of child should be scheduled at six months of age whereby the dentists can provide anticipatory guidance to parents about dos and dont's for the overall dental health. At the first sign of decay parents should visit a paediatric dentist who is trained to initiate treatment to children at a tender age. At the same time preventive strategies like sealants and fluorides can be introduced to prevent the disease. Dental problems, if diagnosed and intercepted early, can be prevented to a big extent. — The writer is a Ludhiana-based dentist and M.D.S. in Paediatric Dentistry
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FITNESS
AS mothers, we always like our children chubby! But research says that chubby children are not necessarily healthy. Your child may be chubby and yet be undernourished. A child has special dietary needs because childhood is phase of rapid growth. Therefore, a reduced version of an adult diet is not sufficient. Young children have an increased need for calories as well as nutrients, the most important of these being iron and calcium. 
Children need help in making wise snacking choices. Most parents provide healthy meals to their children, but do not give adequate attention to their snacking choices. Healthy snacks would include fruits, nuts (almonds & peanuts) sprouts bhel, vegetable frankies (made with whole-wheat flour), milk products like curd, cottage cheese (paneer), tofu (made from soy milk) etc.
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Parents and parents should avoid using sweets and chocolates as rewards to children. Express affection and reward good behaviour and good performance verbally or in kind.
Serving