Wednesday, December 20, 2006

Nutrition in toddlers

Am Fam Physician <http://www.aafp.org/afp/20061101/1527.html> November 1 2006;74:1527-32, 1533-4. © 2006 American Academy of Family Physicians. Nutrition in Toddlers, Richard E. Allen, M.D., M.P.H. and Anya L. Myers, R.D., M.SC.

Pada usia 'toddler' seorang anak mengalami transisi dari bayi menjadi anak, demikian pula dietnya berubah dari diet susu menjadi diet anak yang omnivor. Dalam peralihan ini dokter perlu melakukan monitoring pertumbuhan dan indeks massa tubuh untuk menentukan diet yang sehat bagi sang anak.

Pembatasan makanan berlemak dan kolesterol kiranya belum perlu pada anak <2 tahun. Setelah usia 2 tahun dianjurkan konsumsi lemak 30% dari jumlah total kebutuhan kalori per hari, terutama lemak tak jenuh jamak (polyunsaturated fats). Dianjurkan konsumsi susu atau produk olahan susu (dairy product) setidaknya dua sampai tiga kali sehari. Konsumsi pemanis/minuman manis dibatasi 120-180 gram per hari. Penggunaan multivitamin secara rutin tidak perlu. Dianjurkan konsumsi berbagai golongan makanan.

Karena anak cenderung meniru orang tuanya maka parental modeling perlu dalam rangka membentuk kebiasaan makan yang baik bagi sang anak. Tidak ada bukti kuat bahwa obesitas pada usia anak berhubungan dengan obesitas pada usia dewasa, sehingga lebih baik anak tidak kurang gizi daripada khawatir terjadinya obesitas pada usia toddler.

Toddlers make a transition from dependent milk-fed infancy to independent feeding and a typical omnivorous diet. This stage is an important time for physicians to monitor growth using growth charts and body mass index and to make recommendations for healthy eating. Fat and cholesterol restriction should be avoided in children younger than two years. After two years of age, fat should account for 30 percent of total daily calories, with an emphasis on polyunsaturated fats. Toddlers should consume milk or other dairy products two or three times daily, and sweetened beverages should be limited to 4 to 6 ounces of 100 percent juice daily. Vitamin D, calcium, and iron should be supplemented in select toddlers, but the routine use of multivitamins is unnecessary. Food from two of the four food groups should be offered for snacks, and meals should be made up of three of the four groups. Parental modeling is important in developing good dietary habits. No evidence exists that early childhood obesity leads to adult obesity, but physicians should monitor body mass index and make recommendations for healthy eating. The fear of obesity must be carefully balanced with the potential for undernutrition in toddlers. (Am Fam Physician 2006;74:1527-32, 1533-4. Copyright © 2006 American Academy of Family Physicians.)

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