Protein and mineral deficiencies in children

Calcium
Benefits

1. One of the important macro minerals in the body.
   
2. Helps to build strong bones.
   
3. It is involved in Neuromuscular, enzymatic, hormonal, and other metabolic activities.
   
4. Used in blood clotting, muscle contraction and maintenance of cell membranes.
   

Note

1. Vitamin D or exposure to sunlight increases its absorption.
   
2. Calcium decreases with ageing.
   
3. 99 per cent is stored in bones and teeth.
   
4. It is not manufactured by body. Hence, supplementation is a must, especially for vegetarian children.
   

Symptoms of deficiency

1. Bow legs/ Pigeon breast/ Knock-knees in children.
   
2. Cramps in legs.
   
3. Delays in motor milestones.
   
4. Heart beat becomes irregular.
   
5. Weakness of bones.
   
6. Poor sleep disorder.
   

Long term deficiency leads to osteoporosis. Though osteoporosis is the disease of the elderly, today’s young adults who do not expose themselves to sunlight and work long hours in AC rooms also suffer this. Excess of calcium leads to constipation and loss of appetite.

Food sources

Dairy products like milk, cheese, yoghurt, salmon fish, green-leafy-vegetables such as broccoli, spinach, calcium fortified foods, ice creams.

Protein
Benefits

An important component of every cell in the body, protein is needed to build strong structures in the body (bones, muscles, tendons, ligaments), to rebuild body tissues and to produce enzymes.

Protein Energy Malnutrition (PEM) It is a manifestation of chronic under-nutrition, consuming food with insufficient protein energy or both. Both Marasmus and Kwashiorkor come under the PEM category.

Causes of Kwashiorkor

1. Early weaning and feeding of starch rich cereals.
   
2. A diet high in starch and low in proteins.
   

Symptoms

1. Fluid collection in the body.
   
2. Thin extremities
   
3. Liver enlargement
   

In Marasmus, the body utilizes its own tissue for energy and appears skeleton like. Children also have:

1. Poor appetite
   
2. Sparse hair
   
3. Anxious look
   

Treatment

1. Provide adequate nutrition
   
2. IV fluids if necessary
   
3. Treat underlying infections
   

Breast-feeding a baby up to six months is the best way to prevent childhood malnutrition.

Food Sources

Dairy and egg products, meat, fish, grains, nuts, beans

Iron
Benefits

Iron is essential for the child’s growth and development. It moves oxygen from the lungs to the rest of the body and helps the muscles to use and store oxygen.

Children at risk of facing iron deficiency are:

1. Babies born prematurely or having low birth weight
   
2. Babies on cow’s milk before the age of 1
   
3. Breast-fed babies who are not given iron after six months
   
4. Babies on formula which is not fortified with Iron
   
5. Children with chronic infections or restricted diets
   
6. Children who drink more than 700 ml of cow’s, soy or goat milk everyday
   
7. Adolescent girls who lose Iron during menstruation
   

Symptoms of deficiency

1. Fatigue or weakness
   
2. Pale skin
   
3. Poor appetite
   
4. Shortness of breath
   
5. Irritability
   

Untreated Iron deficiency in children can cause physical and mental delays in areas such as walking or talking.

Prevention

1. Breast feed or give iron-fortified formula to infants
   
2. Encourage a balanced diet
   
3. Enhance absorption with Vitamin C
   
4. Give iron supplements
   

Food Sources

Lean red meat, seafoods, all kinds of beans, greens, tofu, broccoli, drumsticks, brussel sprouts, nuts and dried fruits, egg yolk.

Dr Santha Narayanan is a practising paediatrician from Chennai.

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