Prevention, Wellness and Early Childhood Nutrition

The major focus of medicine is on treating the illness. While prevention and wellness have received more attention recently, they have not yet become key components of the medical care physicians provide routinely to their patients.  More often prevention and wellness are treated as the responsibility of patients. Although we are improving our understanding of what is necessary to maintain good health, we continue to have high rates of preventable death and a system which arguably remains overly focused on treating illness.  For no group is a prevention and wellness strategy more important than it is for our children.

Our most consistent and effective prevention strategy is undoubtedly in the area of childhood immunizations.  But even in this area many children are left out, particularly children of foreign guest workers, illegal immigrants or the uninsured, all of whom tend to come into the health care system only in case of emergency. We risk their health and wider scale transmission of childhood communicable diseases by not including them.

We have been far less successful in influencing childhood nutrition. Poorly prepared, over-cooked, and highly processed foods devoid of nutritional value pervade our ubiquitous fast food, drive through, quick service economy. Such food fills children up without providing  the nutrients they need to nourish their growing bodies. There are about 40 important micronutrients present in fruits and vegetables which are all but absent (particularly vegetables) in the diet of many children. Without these nutrients, even children who overeat routinely can be malnourished.  Coupling that with the increasingly sedentary nature of children’s activities has resulted in a childhood obesity epidemic which is all too obvious. Reversing obesity in children will require the concerted and cooperative efforts not only of physicians and parents, but schools, businesses, communities, the media, and children themselves.

Micronutrients are implicated in more than the obesity problem. Missing these important elements may also affect development of both the nervous system and the immune system, making children more prone to both affective brain disorders and infectious disease, respectively. While the connections are not entirely clear, there is an increased incidence of both among children despite the fact that we have better drug treatments for these conditions than ever before.

We can and we should do a better job with early childhood nutrition. Four to six portions of fruits and vegetables per day is something to shoot for—those low in starch are preferred (lower GI index). Make a list.  Find out what your child likes and keep good choices available. Also, if you are a woman in her child bearing years, keep a good nutritional profile. You need fresh fruit and vegetables as well as adequate protein.  It is better to present the fetus with adequate nutrition from the start, than to wait until your doctor puts you on a pre-natal nutrition enhancement program.

It should be pointed out that getting essential micronutrients through adequate amounts of fruits and vegetables in the diet also decreases cancer risk, and is, therefore, important throughout the life span.  In the United States, cancer and heart disease account for about two-thirds of all deaths. Further, about half of all reported deaths are from preventable causes, nearly 70% of which are due to tobacco use, poor diet and associated physical inactivity.  While in the past tobacco use was the more important cause, poor diet and associated physical inactivity have been catching up.

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