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1 Focused Issue of This Month Nutrition in Childhood for Lifelong Health Jeong Wan Seo, MD Department of Pediatrics, Ewha Womans University School of Medicine E - mail : jwseo@ewha.ac.kr J Korean Med Assoc 2009; 52(3): The childhood and adolescence is an important period for establishing lifelong health. If parents want their children to live a healthy life, they should fix their children a nutritionally balanced diet and they should encourage their children to have a healthy eating habits and active physical activity. The beginning of lifelong health should be breastfeeding which reinforces immunity. What parents need to do is preparing nutritionally balanced meals at certain place at regular times. Children themselves control the amount of food they need to take. The parents should be a role model of their children to improve their childrens' healthy lifestyle. After 2 years of age, fat intake must be gradually decreased to 30~35% of total energy intake. The parents should limit their children eating saturated or trans fatty acids. Sweet or salty taste should be given as late as possible, and the parents should make efforts to give their children fruits and vegetables at each meal. Also they have to serve milk, dairy products, beans, tofu which are abundant of calcium. Traditionally, physicians has been treating sick children but nowadays physicians have to ask about childrens health before anything else and inform the parents what to do to keep their children healthy. Keywords: Childhood; Nutrition; Eating habits Abstract 233

If parents want their children to live a healthy life, they should fix their children a nutritionally balanced diet and they should encourage their children to have a healthy eating habits and active

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3 Nutrition in Childhood for Lifelong Health 235

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5 Nutrition in Childhood for Lifelong Health Table 1. Dietary reference intakes for Koreans (KDRIs)-acceptable macronutrient distribution ranges Macronutrients Age 1~2 y 3~19 y Adults Carbohydrate 50~70% 55~70% 55~70% Protein 7~20% 7~20% 7~20% Fat 20~35% 15~30% 15~25% The Korean Nutrition Society,

distribution ranges Macronutrients Age 1~2 y 3~19 y Adults Carbohydrate

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7 Nutrition in Childhood for Lifelong Health 239

8 Seo JW Table 2. Dietary reference intakes for Koreans (KDRIs) for calcium and vitamin D in children. The Korean Nutrition Society, 2005 Age Calcium (mg/d) Vitamin D (/d) EAR RI AI UL AI UL Infants 0~5 mo ~11 mo Children 1~2 y , ~5 y , Males 6~8 y , ~11 y , ~14 y 800 1,000 2, ~19 y 800 1,000 2, Females 6~8 y , ~11 y , ~14 y , ~19 y , EAR (Estimated Average Requirements), RI (Recommended Intake), UL (Tolerable Upper Intake Level), Vitamin D: 1 =40 IU. 240

60 3~5 y 400 600 2,500 10 60 Males 6~8 y 550 700 2,500 10 60 9~11 y 550 800 2,500 10 60 12~14 y 800 1,000 2,500 10 60 15~19 y 800 1,000 2,500 10 60 Females 6~8 y

9 Nutrition in Childhood for Lifelong Health 11. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, Oh K, Jang MJ, Hwang SS, Yoo MH, Kim YT, Lee CG Korean national growth charts: review of developmental process and an outlook. Korean J Pediatr 2008; 51: De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007; 85: Somers L. Food allergy: nutritional considerations for primary care providers. Pediatr Ann 2008; 37: Eriksson J, Forsen T, Tuomilehto J, Osmond C, Barker D. Size at birth, childhood growth and obesity in adult life. Int J Obes Relat Metab Disord 2001; 25: Hediger ML, Overpeck MD, McGlynn A, Kuczmarski RJ, Maurer KR, Davis WW. Growth and fatness at three to six years of age of children born small- or large-for-gestational age. Pediatrics 1999; 104. Available at: cgi/content/full/104/3/e

Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007; 85: 660-667. 13. Somers L.

10 Seo JW 16. Frisancho AR. Prenatal compared with parental origins of adolescent fatness. Am J Clin Nutr 2000; 72: Gunderson EP, Abrams B, Selvin S. The relative importance of gestational gain and maternal characteristics associated with the risk of becoming overweight after pregnancy. Int J Obes Relat Metab Disord 2000; 24: Berni Canani R, Passariello A, Buccigrossi V, Terrin G, Guarino A. The nutritional modulation of the evolving intestine. J Clin Gastroenterol 2008; 42: S Waker WA. Eat, Play, Be Healthy. Boston: Mcgraw-Hill Co., 2005: Arenz S, Ruckerl R, Koletzko B, von Kries R. Breast-feeding and childhood obesity: a systematic review. Int J Obes Relat Metab Disord. 2004; 28: Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics 2005; 115: Martin RM, Gunnell D, Smith GD. Breastfeeding in infancy and blood pressure in later life: systematic review and metaanalysis. Am J Epidemiol 2005; 161: Owen CG, Whincup PH, Kaye SJ, Martin RM, Davey Smith G, Cook DG, Bergstrom E, Black S, Wadsworth ME, Fall CH, Freudenheim JL, Nie J, Huxley RR, Kolacek S, Leeson CP, Pearce MS, Raitakari OT, Lisinen I, Viikari JS, Ravelli AC, Rudnicka AR, Strachan DP, Williams SM. Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. Am J Clin Nutr 2008; 88: Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG. Infant feeding and blood cholesterol: a study in adolescents and a systematic review. Pediatrics 2002; 110: Mennella JA, Griffin CE, Beauchamp GK. Flavor programming during infancy. Pediatrics 2004; 113: Mennella JA, Pepino MY, Reed DR. Genetic and environmental determinants of bitter perception and sweet preferences. Pediatrics 2005; 115(2). Available at: content/full/115/2/e Gerrish CJ, Mennella JA. Flavor variety enhances food acceptance in formula-fed infants. Am J Clin Nutr 2001; 73: Seo JW, Kim YJ, Lee KH, Kim JY, Sim JG, Kim HS, Ko JS, Bae SH, Park HS, Park BS. A survey on the understanding of breast-feeding in pregnant woman. J Korean Pediatr Soc 2002; 45: Gidding SS, Dennison BA, Birch LL, Daniels SR, Gillman MW, Lichtenstein AH, Rattay KT, Steinberger J, Stettler N, Van Horn L; American Heart Association. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics 2006; 117: Allen RE, Myers AL. Nutrition in toddlers. Am Fam Physician 2006;74: Nicklas TA, Hayes D; American Dietetic Association. Position of the American Dietetic Association: nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc 2008; 108: Dietary Reference Intakes for Koreans(KDRIs); The Korean Nutrition Society, Seoul: Kukjin Co., 2005; Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program''s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a metaanalysis. Am J Clin Nutr 1999; 69: Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: Van Horn L, Obarzanek E, Friedman LA, Gernhofer N, Barton B. Children''s adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC). Pediatrics 2005; 115: Obarzanek E, Kimm SY, Barton BA, et al. Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children (DISC). Pediatrics 2001; 107: Kaitosaari T, Ronnemaa T, Raitakari O, et al. Effect of 7-year infancy-onset dietary intervention on serum lipoproteins and lipoprotein subclasses in healthy children in the prospective, randomized Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study. Circulation 2003; 108: Lagstrom H, Jokinen E, Seppanen R, et al. Nutrient intakes by young children in a prospective randomized trial of a low saturated fat, low-cholesterol diet: the STRIP Baby Project. Special Turku Coronary Risk Factor Intervention Project for Babies. Arch Pediatr Adolesc Med 1997; 151: Talvia S, Lagstrom H, Rasanen M, et al. A randomized intervention since infancy to reduce intake of saturated fat: calorie (energy) and nutrient intakes up to the age of 10 years in the Special Turku Coronary Risk Factor Intervention Project. Arch Pediatr Adolesc Med 2004; 158: Slavin JL. Position of the American Dietetic Association: health implications of dietary fiber. J Am Diet Assoc 2008; 108: Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008 ; 122:

Berni Canani R, Passariello A, Buccigrossi V, Terrin G, Guarino A. The nutritional modulation of the evolving intestine. J Clin Gastroenterol 2008; 42: S197-200. 19. Waker WA. Eat, Play, Be Healthy.

11 Nutrition in Childhood for Lifelong Health 32. Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr 2008; 88: 500S-506S. 33. Harris SS. Vitamin D in type 1 diabetes prevention. J Nutr 2005; 135: Holick MF.Vitamin D deficiency. N Engl J Med 2007; 357: Kim WK. Diagnosis and treatment of food allergy in children. Pediatr Allergy Respir Dis 2006; 16: Park YS, Lee DH, Choi JM, Kang YJ, Kim CH. Trend of obesity in school age children in Seoul over the past 23 years. Korean J Pediatr 2004; 47: Oh K, Jang MJ, Lee NY, Moon JS, Lee CG, Yoo MH, Kim YT. Prevalence and trends in obesity among Korean children and adolescents in 1997 and Korean J Pediatr 2008; 51: Relationship of atherosclerosis in young men to serum lipoprotein cholesterol concentrations and smoking: a preliminary report from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. JAMA 1990; 264: Yom HW, Shin JS, Lee HJ, Park SE, Jo SJ, Seo JW. The metabolic syndrome in obese children. Korean J Pediatr Gastroenterol Nutr 2004; 7: Cho KY, Park H, Seo JW. The relationship between lifestyle and metabolic syndrome in obese children and adolescents. Korean J Pediatr Gastroenterol Nutr 2008; 11: Peer Reviewers Commentary 243

Diagnosis and treatment of food allergy in children. Pediatr Allergy Respir Dis 2006; 16: 274-283. 36. Park YS, Lee DH, Choi JM, Kang YJ, Kim CH.

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386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon