drabhijit

Fats are essential for normal growth and development. Lipids/fats are an integral part of each and every cell of our body. They are even more important in children and small babies to have a well-developed brain and other nerve tissues.

Role of fat in the diet:

1. To provide fuel for body/energy source: fats are the major source of energy in children’s diet.
2. They are essential for the absorption of some vitamins (A, D, E, K)
3. Fats are major building blocks of hormones.
4. We get essential fatty acids from fat we eat (fatty acids which are not synthesized in our body)
5. Fats slow gastric emptying leading to satiety so that we stop eating
6. Fats improve how food tastes. Without fat, foods will become tasteless.

But at the same time, we have to remember fats have more than twice the amount of calories as carbohydrates or protein. (1 gm fat give 9 kcal energy while carb and protein give only 4 kcal/gram)

Parents have a general impression that children should not have a dietary restriction of fat.  

Why we worry about fat (concern about fat) in diet

1. A rapid increase in weight during early life is associated with the future risk of overweight and obesity.
2. Studies suggest that partially breastfed and formula-fed infants consume 20% more total calories per day than exclusively breastfed infants.
3. Early life rapid weight gain increases the chances of having many chronic diseases in adult life like diabetes, hypertension, dyslipidemia, and heart diseases.

Types of fats in diet:

1. Visible fat: what we can see in the naked eye like oils, butter
2. Invisible fat: each food has some amount of fat in it. It has to be remembered that invisible fat can contribute up to 50% of the recommended daily intake of fats in our regular diet.
3. Hidden fat: fats present in processed and Ready to Eat foods. They are totally undesirable.

Another classification of fats is according to their biochemical structure

1. Unsaturated fats: seen as neutral or even beneficial to heart health. Unsaturated fats are:

• Monounsaturated (MUFA)
• Polyunsaturated (PUFA)-omega 3 like Alpha-linolenic acid(ALA) and omega 6 like Linoleic acid(LA)

Good source of unsaturated or relatively healthy fats: 

              non-veg- fishes like tuna, salmon, cord, trout, hilsha, crab, shrimp

              Veg– Olive oil,sunflower oil, safflower, soya oil, sesameoil, mustard, rajma, flaxseed oil, walnut

1. Saturated fats: These are most often present in meat and dairy products, such as butter, cheese, and milk (except skim or non-fat). Few plant oils like coconut oil and palm oil are high in saturated fat. Eating a diet high in saturated fat can raise blood cholesterol levels and increase the risk of heart disease.
2. Trans fats: Found in commercial snack foods, baked goods, and some commercially fried foods. Trans fats are created when vegetable/plant oils are heated at high temperatures. This causes hydrogenation( when hydrogen atoms get added to the fat molecule. so they remain solid at room temperature). Food manufacturers have to list trans fats on food labels. But sometimes trans fats are referred to as “partially hydrogenated” oils on the ingredient list. Our body takes years to dispose of trans fat.
3. Cholesterol: present in animal foods like meat, milk, prawn, egg yolk, organ meat like liver but not in plant food. Cholesterol can be synthesized in our body and only a minimal amount of dietary cholesterol is recommended in the diet.

We can synthesize saturated and monounsaturated fatty acids, but cannot synthesize the omega three and the omega six families of polyunsaturated fatty acids(PUFA) . n3 like Alpha linolenic acid(ALA) and n6 like Linoleic acid(LA) should be considered essential and indispensable since they cannot be synthesized by us. While DHA(Docosahexaenoic acid) and AA( Arachidonic acid) can be synthesized from ALA and LA, respectively, they should be considered non-essential, although a dietary supply of DHA and AA may be necessary for long- term health.

However, given the limited and highly variable formation of DHA from ALA (only 1–5%) and because of their critical role in normal retinal and brain development in the human they should be considered conditionally essential during early development. Similarly, they might be considered conditionally essential for life-long health considering intakes required for the prevention of cardiovascular disease [WHO/FAO, 2003]

Ratio of omega 6 to omega 3 (n6: n3)

• The balance in n–6 to n–3 fatty acid intake is based on eicosanoid-related effects

• There are some indications that variations of the ratio of n–6 to n–3 may modulate allergy, inflammation, clotting and vascular responses

• Currently evidence is insufficient to link increased intake levels of DHA and/or EPA(Eicosapentaenoic acid) to improved physical or mental development or specific functional benefits in children aged 2–18 years

• Therefore, quantitative dietary intake recommendations for children cannot be established at this time

• Dietary intake patterns that are advised to adults to prevent chronic diseases will apply to the whole population, including children to consume at least 1 or 2 meals of fatty fish per week

Fats in first 6 months of life:

Breast feeding is the best. It has the most beneficial and right proportions of various fats that your baby needs. The lipid composition of breast milk varies during lactation and according to the mother’s diet. So lactating mothers should be careful about their dietary habits and sources of fats in their food. The lipid composition of infant formulae varies according to the blend of different fat sources they use.

Fats after 6 months:

Parent need to monitor the weight gain of their child with respect to age and length. Goal is to identify infants who are gaining weight rapidly and/or whose weight-to-length percentile exceeds the 95th percentile. It will help to pick those who will need dietary modifications.

Compositions of fats in various cooking oils

(source: ICMR)

Choice of cooking oil:

An ideal quality fat which is good for you and your child should maintain a balance so as to give a good ratio of n3 and n6 fats. Use of more than one source of fat/oil can achieve this goal. Example of oil combination in this regard can be:

(source : ICMR)

TAKE HOME MESSAGE

1. Fats have a wide range of biological actions beyond the supply of energy and are essential for infants’ growth, development, and health.
2. Evidence shows us that the quality of dietary lipids provided to infants has a marked impact on long term health outcomes.
3. A balanced and healthy fat diet during pregnancy and breastfeeding is a must to ensure good fat for the baby.
4. Almost 50 % of dietary allowance of fat in our diet comes from invisible fat.
5. The use of multiple cooking oil is better than a single oil.
6. Change of family dietary practices is primordial to achieve good childhood nutrition outcomes. Be a role model by changing your food behavior before trying to change your child’s food habits.
7. Every child is unique and their dietary requirement of fat varies according to their present weight, rate of weight gain, and coexisting diseases.
8. Always consult with your doctor about how to ensure a healthy fat diet that is best for you and your child
9. Remember high fat intake will lead to obesity and future chronic diseases. At the same time low fat intake with high carbohydrate diet will also increase plasma triglycerides and decrease HDL.So the right balance that is appropriate for your child needed.

To know best practices for managing childhood obesity read this book edited by me

Childhood obesity and adult life

This is a part of #CauseAchatter by Blogchatter

REFERENCES:

1. ICMR
2. WHO
3. Nelson’s textbook of pediatrics
4. Fat and Fatty Acid Requirements and Recommendations for Infants of 0–2 Years and Children of 2–18 Years: Ricardo Uauy, Alan D Dangour

drabhijitmisra.com Disclaimer: All health information provided on this blog is for general awareness and doesn’t in any way replace a doctor’s professional medical advice. Kindly consult your doctor in case of any decision regarding your health, and diet. The information provided is for awareness. This is not meant as professional medical consultation. Healthcare is an individual decision and needs careful discussion and professional consultation before taking any decision. The author is sharing his professional knowledge. This post is meant as educational and awareness information and all decisions to be taken at own risk after consulting their own doctor in person. Health information is constantly being updated and while the author tries his best to keep updated information, the author and the website shall not be held liable for any reliance placed on such content for any reason whatsoever.