NUTRITION FACTSHEETS

Important information on poor nutrition and essential nutrients

NOTES

Hunger is the condition of a person who does not have access to enough food on a daily basis.
Malnutrition is caused by lack of food, poor food quality and variety, and disease. Although a person might be consuming the right quantity of kilocalories (i.e. energy) daily, he/she may still be missing vital nutrients in the diet.

Many children in poor countries and communities have inadequate and unbalanced diets, which result in malnutrition. Poverty, poor sanitation, disease and economic and political instability all contribute.

Children’s growth and behaviour are good indicators of their overall health. If they are small for their age and thin, tired, unable to concentrate and frequently sick, they may be malnourished. The three main kinds of malnutrition are:

• Undernutrition When children are not getting enough of the right mix of foods, they are often tired and do not have the energy to play. Their immune system may be weak so they become ill easily. They may also grow more slowly than normal children and may have problems learning at school. Children who are undernourished are often smaller in height than normal healthy children; they may also have thin arms and legs and their bodies are weak.

  

• Overweight If children eat too much, do not get the right mix of foods, and do not have enough exercise, they can become overweight. This may lead to adult overweight and many health problems, such as heart disease, dia betes and certain types of cancer. Overweight is on the increase in many developed and developing countries.

  

• Micronutrient malnutrition Many children do not get enough of some essential vitamins and minerals. The most common deficiencies are lack of vitamin A, iron, iodine and zinc in the diet. These “micronutrients” carry out vital tasks that make the body work well. They give good sight and skin, protect the body against disease, help to release the energy in food, and allow the brain and body to develop properly.

What are the main causes of hunger and malnutrition?

People living in poverty have limited access to food. For many, malnutrition is the result of lack of money to purchase enough food. Others may not have land on which to produce their own food; sometimes, people who have land may produce too little food to last all year round. Families not able to produce or purchase sufficient food are considered food insecure. Within such families, women and children often have less food than men.

Malnutrition is also caused, and often made worse, by poor living conditions, including insufficient or dirty water, poor sanitation and lack of adequate care within the home. Younger children are more susceptible to infectious diseases, such as diarrhoea, malaria, measles and coughs. Children who get sick often cannot absorb all the nutrients and their bodies will be weak.

HIV/AIDS can be another major cause of hunger and malnutrition. When adults become sick with HIV/AIDS, they are less able to farm or earn money for food. They may also have to sell their assets (cattle, tools) to buy food and medicine. Children who are orphaned often become malnourished if one or both parents are sick or dead. They may lack food and care, or they may eat less because of grief and depression.

Another way in which HIV/AIDS causes malnutrition is because of the immediate effects of the disease. Like other sick people, adults or children living with HIV/AIDS who do not eat well or absorb enough nutrients use their own body tissues for energy and vital nutrients. They lose weight and become malnourished. People living with HIV/AIDS can prevent malnutrition and live longer by eating a healthy balanced diet, practising good hygiene and sanitation, and getting treated early for infectious diseases.

WHAT HAPPENS IF SCHOOL-AGE CHILDREN ARE NOT FED WELL?

School children who are hungry or have poor diets usually grow more slowly than well-nourished children and often have little energy to play, study or do physical work. They are likely to have short attention spans and do not do as well in school as other children. Their educational achievements may be poor and they may drop out of school early. Poor nutrition during childhood not only decreases individual potential; in the long term it can also adversely affect the development of communities and nations.

WHAT IS A HEALTHY DIET?

For children five years and over, a healthy diet means a balanced diet with plenty of variety and sufficient energy for growth and development every day. This consists of:

• Plenty of fibre-rich starchy foods, such as rice, maize, bread, noodles, cassava and yams.

• Plenty of vegetables, such as dark green leafy and orange-coloured vegetables.

• Beans, peas and if possible, small amounts of meat and fish.

• Some dairy products, such as milk, eggs, yoghurt, and cheese.

• A little fat (vegetable oil, butter, ghee) added to relishes, stews and soups adds flavour and helps to absorb the vitamin A in vegetables and fruits.

• Plenty of fruits several times a day, as a snack or as desert after meals. Fruits provide many important vitamins. The vitamin C in fruits helps to absorb the iron from vegetables, such as spinach and other dark green leaves.

• Sweets and sugary foods and drinks should be limited. They are very tasty, provide additional energy and may be eaten or drunk as a special treat. Sweets and sugary foods are not essential for health but add enjoyment to eating!

Mixed Meal Guide

HOW MANY MEALS SHOULD SCHOOL-AGE CHILDREN EAT?

Children should have three meals, plus snacks between meals, every day.

• Breakfast, the first meal is always important but especially if a child has to walk a long way to school and does not eat much at midday. One example of a good breakfast is starchy food (bread, porridge, roasted cassava or sweet potato) with milk, peanut butter or cooked beans, and fruit.

  

• A snack, mid-morning keeps up children’s energy for play and study.

• A meal in the middle of the day containing a variety of foods. If school meals are not provided, parents should give children food to take to school (for example: bread, or roasted cassava, tortilla, chapatti, sweet potato, plus an egg and fruit). If schools provide meals or snacks, these should be as nutrient-rich as possible. Foods from the home or school garden can add variety and nutritional value (see recipes for school meals with garden foods in Nutrition Factsheet 3).

• An evening meal may be the biggest meal of the day for many children and so it should be a good mixed meal (see mixed meal guide). Parents should know that fast growing children are usually hungry children and that they are not being greedy if they want a lot of food. Giving children their own plates makes it easier to check that they are getting enough of every kind of food.

NUTRITIONAL NEEDS OF SCHOOL-AGE CHILDREN

School children need plenty of good food, as their energy and nutrient needs are particularly high in relation to their size. In their overall diet, it is often difficult to achieve adequate intakes of energy, vitamin A, calcium, iron, zinc and iodine. Parents, teachers and school catering staff need to ensure that children receive plenty of nutrient-rich foods.

NUTRITION GUIDELINES AND STANDARDS FOR SCHOOL MEALS

Some countries have minimum national nutrition standards for school meals. These standards give the recommended nutrient content in an average meal for children over a one-week period. They also provide guidance on the types and quality of foods to be served. In a few countries, such guidelines are compulsory and set out in legislation. Check with your national ministry of education or health to find out whether your country has such guidelines. If your country does not have guidelines for school meals, find out whether there are national food-based dietary guidelines. These provide a good basis for promoting healthy diets within and outside the school. They can also guide school cafeteria personnel in menu planning and the preparation of nutritious school meals.

ADDITIONAL RECOMMENDATIONS FOR SERVING FOOD AND DRINKS IN SCHOOLS

• Clean drinking water should always be available to all pupils every day free of charge.

  

• Drinking milk should be available as an option every day.

• Schools should offer a variety of foods and a selection of different meals over the course of the week.

• Schools should always use iodized salt in meal preparation.

• Schools should try to purchase most meal ingredients locally. This ensures that vegetables and fruits are fresh, reduces transport costs and helps to retain wealth in local communities.

• Schools should offer a cooked meal, particularly in cold climates in the winter months. A school lunch does not have to be hot, but a cooked meal can be a morale booster during the colder months.

• School meals should reflect the likes and dislikes of children.

• Healthy eating messages and school meals should complement and reinforce each other, so as to create synergy and promote lifelong healthy eating practices.

• Soft drinks, sweets and very fatty and salty foods, such as burgers and crisps, should be kept out of the school environment. They give poor nutritional value.

NOTES

¹ Information for this factsheet has been provided from the FAO publication (2004) Family Nutrition Guide (Appendix 1 and 2) by Ann Burgess and Peter Glasauer

Table 1. Useful sources of nutrients

CARBOHYDRATES

FATS

PROTEINS

IRON

VITAMIN A

ZINC

FOLATE

VITAMIN C

Table 2. Energy, protein and fat content of some foods

Source: FAO. 1993. Food and nutrition in the management of group feeding programmes. Rome.

kcal = kilocalorie.

MJ = megajoules (joules are the modern unit for measuring energy. 1 000 kcal = 4.18 MJ).

%EP = Percent edible portion = proportion of the ‘as-purchased’ weight of food which can be eaten expressed as a percentage.

- = trace.

* = values calculated. The amount of flour in thick and thin maize ‘porridge’ varies. These are approximate values only.

Table 3. Nutrients in selected foods

Source: Adapted from Burgess et al., Community nutrition for Eastern Africa, AMREF, Nairobi (1994)

¹ Information for this factsheet has been provided from the FAO publication (2004) Family Nutrition Guide (Appendix 1 and 2) by Ann Burgess and Peter Glasauer.

Daily recommended intake for energy and nutrients

Sources: Energy - FAO. 2004. Human energy requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. FAO Food and Nutrition Paper No. 1. Rome; Protein - WHO. 1985. Energy and protein requirements. Technical Report Series 724. Geneva; Micronutrients - FAO/WHO. 2002. Human vitamin and mineral requirements. Report of a Joint FAO/WHO Expert Consultation. Rome.

NOTES

kcal = kilocalorie;

MJ = megajoules (joules are the modern unit for measuring energy. 1 000 kcal = 4.18 megajoules

RE = retinol equivalents;

DFE = dietary folate equivalents

a Full-term babies are born with sufficient iron stores for six months.

b Amount needed when menstruation starts.

c needed after menopause.

d Needs are so high that iron supplements are usually recommended for pregnant women and pregnant adolescent girls

These values assume that:

• children are breastfed for at least the first year;
• older children and adults eat small amounts of iron-rich foods (e.g. meat), other animal proteins and vitamin C-rich foods, and large amounts of staple foods such as maize. The bio-availability values used for iron are ‘10% bio-availability’, and those used for zinc are ‘low bio-availability’;
• adults have moderate physical activity.

Notes