Nutritional regimen to help children grow taller in the first 1,000 days of life

Opportunity for maximum physical and intellectual development

Dr. Nguyen Van Tien, Institute of Nutrition, many studies in the world have proven that: in these 1000 golden days, children who are properly nourished will have a good immune system and develop their full physical and intellectual potential in the future. Proper nutrition will reduce the risk of death in children under 5 years old by 20%, children will have a higher IQ, better learning ability and higher income when they grow up.

On the contrary, if a child is not properly nourished in the first 1000 days of life, he or she will miss the opportunity to develop physically and mentally to the fullest. If a child is stunted as a child, he or she will also be short as an adult. If a child develops well as a child, he or she will become a tall adult. The nutritional regime in the first 1000 days of a child's life depends on each milestone: the mother's pregnancy (270 days), breastfeeding and complementary feeding (365 days - the first year of raising a child) and the diet of a child from 1 to 2 years old (365 days - the second year of raising a child).

During pregnancy, the mother needs to gain 10 - 12 kg to give birth to a baby weighing about 3000 grams. The mother's weight gain and the baby's weight at birth depend on the mother's diet. If the diet has a low energy level, the mother gains little weight, which will increase the risk of the baby being born weighing less than 2500 grams (fetal malnutrition).

Weight gain depends on diet, work, rest and nutritional status of the mother before pregnancy. Daily dietary energy requirement: for women (not pregnant) is 2050 Kcal, during the first 3 months of pregnancy add 50 Kcal (2050 + 50), during the second 3 months of pregnancy add 250 Kcal, during the last 3 months add 450 Kcal and when breastfeeding add 500 Kcal/day.

Pregnant women, women of childbearing age, and adolescent girls need to take iron/folic acid tablets or multivitamin tablets to prevent iron deficiency anemia. For non-pregnant women, take iron/folic acid supplements (60 mg elemental iron, 2800 mcg folic acid), 1 tablet/week (on a certain day) for 3 months, stop for 3 months, then continue taking supplements for 3 months. Iron/folic acid supplements can be repeated this cycle during the year.

For pregnant women, take iron/folic acid supplements (60 mg elemental iron and 400 mcg folic acid), dose 1 tablet/day from the beginning of pregnancy until 1 month after giving birth.

When giving birth, mothers need to breastfeed their babies within the first hour. Breastfeeding early helps the milk come down quickly, the uterus contracts and colostrum is very good for the baby because colostrum has high nutritional value, antibodies against diseases, is easy to digest for the baby and helps to eliminate meconium. Breastfeed your baby exclusively for the first 6 months and breastfeed until 18-24 months of age.

From the 7th month, in addition to breast milk, children need to be fed additional food (supplementary food). The number of meals per day depends on the age of the child: 6 months old eat 1 meal of thin porridge, 7-9 months old eat 2-3 meals of thick porridge, 10-12 months old eat 3-4 meals of thick porridge. Children from 1-2 years old need to eat 4 more meals/day in addition to breastfeeding. Drink 400-500 ml of milk per day (if there is no breast milk).

Weight and height according to standards for each age group

A healthy, normally developing child, when eating enough, will gain weight every month. The average weight of a healthy, full-term newborn is about 3000 grams (3kg); in the first 3 months, the child grows very quickly, gaining 1000-1200g/month; in the next 3 months, the child gains 500-600g/month; in the next 6 months, the child only gains 300-400g/month, and at 1 year old, the child weighs 3 times more than at birth (about 9-10 kg).

Children from 2-10 years old gain an average of 2.4 kg/year in weight and can be calculated by the following formula: Xn = 9.5 kg + 2.4 kg x (N-1).

Xn is the child's current weight (kg); 9.5 is the child's weight at 1 year old; 2.4 is the average weight gain in 1 year; N is the child's age (in years).

The average length of a newborn is about 50 cm. In the first 3 months, the baby increases 3-4.5 cm/month, in the next 3 months it increases 2-2.5 cm/month, in the next 3 months it increases 2 cm/month, and in the following months it increases 1-1.5 cm.

When a 1-year-old child is 1.5 times longer than when he was born (75 cm), a 2-year-old child is 86-87 cm tall (half the height of an adult), a 3-year-old child is 95-96 cm tall, and children from 4 to 10 years old increase in height by an average of 6.2 cm/year and the following formula can be applied: Xc = 95.5 cm + 6.2 cm x (N-3).

Xc is the child's recommended height (cm); 95.5 is the child's height at 3 years old; 6.2 is the average height increase in 1 year; N is the child's age (in years).

Adolescence (10-18 years old): Adolescence is a transitional stage of development from childhood to adulthood: "No longer a child, but not yet an adult". To have good height and nutritional status as an adult, and good health in the pre-marital period, early nutritional interventions help children develop optimally in height. Nutrition for adolescents is very important, because this age group develops rapidly in both height and weight.

The average weight during this period increases from 3-5 kg/year, height can increase from 10-15 cm/year and boys develop more than girls. Therefore, children's nutritional needs are very high for development as well as activities, children often eat without knowing when they are full. Nutritional needs for this age, first of all, are the issue of energy, this need depends on gender and age. But some girls eat less to maintain their body shape, which limits their development.

Reasonable energy needs

Energy: Energy needs range from 1,900-2,300 kcal/day/female and 2,100-2,800 kcal/day/male. To meet the needs, children need to eat 3 meals a day, eat enough and have enough nutrients.

Protein: Protein is essential for height and weight growth, because protein helps create cell structure, creates hormones and responds to the body's immune system.

Daily protein requirement is 50-70g/male and 50-60g/female, the ratio of animal protein/total protein is ≥ 35%, energy from protein accounts for 13-20% of the energy of the diet. Animal protein sources for meals include meat, fish, eggs, milk, shrimp, crab... Plant protein sources include beans, sesame, peanuts, etc.

Fat: Fat is a source of energy, helping to dissolve and absorb fat-soluble vitamins: vitamins A, E, D, K. The need for lipids is 60-78 g/day/male and 55-66 g/day/female, the balance between animal lipids and vegetable lipids is 70% and 30%. The energy provided by lipids in the diet accounts for about 20-30%.

Iron: Daily iron requirements are met through a diet rich in iron and iron of high biological value. However, in our country, the ability to access animal food sources with high biological value iron from the diet is very low. Therefore, from the early stages of adolescence, especially girls, need to take iron or multivitamin supplements weekly.

Vitamin A: Essential for normal growth and development, enhancing immunity, reducing infection and mortality rates. Vitamin A is abundant in animal foods such as liver, eggs, milk...; plant foods provide sources of carotenoids such as green vegetables, fruits, and yellow fruits. The daily vitamin A requirement for adolescents is 800 µg/day/male and 650 µg/day/female.

Calcium: Very necessary for puberty because height growth is very fast, calcium demand is high, so calcium requirement is 1000 mg/day. Calcium and phosphorus maintain and form strong bones and teeth.

The vitamin D requirement for adolescents is 15 µg/day. Milk is a source of protein and calcium. For children who do not like to drink milk, they can use dairy products such as yogurt, cheese or use calcium-rich foods such as shrimp, crab, fish and seafood.

Zinc: Zinc is essential for growth in both body weight and height. Zinc deficiency affects the metabolism of taste cells, causing loss of appetite due to taste disorders. The daily zinc requirement is 9-10 mg/male and 7-8 mg/female. Foods rich in zinc are freshwater shrimp, eel, oysters, clams, pig liver, milk, beef, egg yolks, fish, soybeans, oil seeds (almonds, cashews, peanuts...).

Vitamin C: Vitamin C helps absorb and use iron, calcium and folic acid. In addition, it also has anti-allergy functions, increases immunity, stimulates bile production, and protects blood vessels. Vitamin C is abundant in green vegetables and ripe fruits. The vitamin requirement for adolescents is 95 mg/day./.