Health development: A nutritional assessment in preschools
Children who have proper nutritional status are generally in better health and have a decreased risk for developing disease in the future. A nutritional assessment can detect any abnormal ranges at an early age so that lifestyle changes can take place before the problem elevates into something more serious with adverse consequences. The purpose will be to provide a nutritional status profile of children who attend Child and Family Study Center at Sri Lanka. Assessment of nutritional status is useful to estimate growth patterns and identify signs and symptoms associated with malnutrition or excessive nutritional intake. Nutritional status is determined from nutritional assessment of dietary, socioeconomic and drug-nutrient interaction effects thus, reflecting a child's nutrient requirements for optimal health and nutritional status (Mahan and Escott-Stump, 2000). Determining nutritional status can lead to early detection of nutritional deficiencies that can lead to increased morbidity and mortality. Early nutritional support can improve nutritional status, minimizing the chances for innocuous problems becoming more serious. Nutritional assessment should be a routine procedure for preschoolers demonstrating preventive stance. Indeed, proper nutrition levels are generally associated with better health status among children and later health when these children reach adolescence and adulthood. For example, research shoes that some disease states in later life have origin in childhood.
Furthermore, Hayman (1983, pp. 9-17) indicated that, nutritional assessment of the preschool child require variety of invasive and noninvasive techniques for example, dietary history, physical examination, clinical observations, anthropometric data and biochemical studies. The purpose of assessment will dictate the methods used, whereas the setting dictate sequence in which they are used. Research will examine the methods from an organismic-ecological perspective (Hayman 1983, pp. 9-17) and emphasize methods of nutritional assessment that are applicable in the preschool setting. Criteria for identifying children at nutritional risk, commonly encountered altered nutritional outcomes, as well as implications for interdisciplinary assessment and intervention will be discussed.
Nutrient intakes of preschool-age children will be assessed with 24 hour dietary recall and 1 month food frequency questionnaire (FFQ). Parents of 30 preschoolers will complete the recall and FFQ on certain occasion for about one week apart and be analyzed for energy, cholesterol, protein, carbohydrates as well as potassium and saturated as well as polyunsaturated and monounsaturated fats and each nutrient will be expressed as raw value, value per kg body weight and value per 1,000 kcal (Tungbilek, Unalan and Coskun, 1993). Test-retest reliability estimates for the 24-hour recall can indicate variability in energy intake, but stable report of intake will be observed for one unit of expression for polyunsaturated fats, cholesterol, protein, carbohydrates and potassium. FFQ may be useful in epidemiological studies of preschoolers' intakes over extended periods, the recall may prove to be useful tool in the assessment of day to day variations in macronutrient intakes of the preschool (Tungbilek, Unalan and Coskun, 1993). The need for an intersectoral approach to reduce the effect for periodic assessment of nutritional status of preschool children will be stressed out. In order to assess the current nutritional status and pattern of food intake of preschool children the Department of Social and Preventive Medicine, Government Medical College Srinagar, have conducted randomized study of 428 households in a typical rural block of J&K State. Nutritional anthropometry revealed that the majority of the studied preschoolers (62.5 percent) were normal; 35.9 percent had mild malnutrition while only 1.6 percent exhibited moderate malnutrition. No child was found to be suffering from severe forms of malnutrition. Weight-for-height studies also revealed that only 18.4 percent were stunted. Dietary assessment revealed that the studied population was deficient in respect of their calorie intake but adequate in protein consumption. Research must be stressed that both systems, being based on weight as the basis of classification, do not consider body composition and therefore can only assess whole body mass and thus only approximate the nutritional status. References Laura Hayman (1983) Nutritional assessment of handicapped preschoolers Topics in Early Childhood Special Education, Vol. 3, No. 2, 9-17 Ergul Tungbilek, Turgay Unalan and Turgay Coskun (1993) Indicators of Nutritional Status in Turkish Preschool Children: results of Turkish Demographic and Health Survey 1993 Mahan, L.K & Escott-Stump, 5. (2000) Krause's Food, Nutrition, & Diet Therapy (1 0 th ed.). Philadelphia, PA: W.B. Saunders Co.
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