M Lawson, Institute of Child Health, London, UK © 2005 Elsevier Ltd. All rights reserved.
Nutrition is particularly important in childhood because nutrients are required not only for general health and maintenance of body composition but also for linear growth, neurological development, body maturation, and as a basis for long-term health. There is considerable evidence of an association between early nutrition and later risk of diseases such as cardiovascular disease, obesity, and type 2 diabetes.
Two major factors affect nutrient requirements during infancy, childhood, and adolescence: body size and growth velocity. Growth velocity varies according to age, and age is used as a general
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proxy for weight velocity. Nutritional requirements for children should therefore be expressed in terms of units of body weight for each age throughout childhood. Nutrient requirements per unit of body weight are highest at birth and reduce as growth velocity decreases.
The pattern of nutrient requirement changes and is not constant per unit of body weight as body composition changes throughout the growing period from birth until the end of puberty. This is illustrated in Figure 1, which shows the changes in energy and protein requirements per kilogram body weight between birth and 15 years. Nutrient requirements are therefore both quantitatively and qualitatively different from those of adults.
For infants, breast milk is used as a model for assessing nutrient requirements. However, although breast milk is the 'gold standard' on which infant formulas are based, the physiological actions of nutrients and other components of breast milk and
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