chronic diseases in adulthood. Children require sufficient energy, protein, and other nutrients for growth as well as maintenance of body functions. Nutrient needs tend to parallel rates of growth. Growth continues at a steady rate during childhood, then accelerates during adolescence, creating increases in nutrient needs to support the rapid growth rate and increase in lean body mass and body size (Story et al., 2002a). During puberty, adolescents achieve the final 15 to 20 percent of stature, gain 50 percent of adult body weight, and accumulate up to 40 percent of skeletal mass (Story et al., 2002a). Inadequate intakes of energy, protein, or certain micronutrients will be reflected in slow growth rates, delayed sexual maturation, inadequate bone mass, and low body reserves of micronutrients (Story et al., 2002a).

In addition to the impact on growth and development, children’s diets are important to ensure overall health and well-being. Dietary practices of children and adolescents affect their risk for a number of health problems, including obesity, iron deficiency, and dental caries. Inadequate nutrition also lowers resistance to infectious disease, and may adversely affect the ability to function at peak mental and physical ability. Obesity in children and adolescents is associated with a number of immediate health risks, such as high blood pressure, type 2 diabetes (T2D), metabolic syndrome, sleep disturbances, orthopedic problems, and psychosocial problems (Daniels, 2006; IOM, 2005b). Furthermore, obese adolescents are likely to remain overweight as adults (IOM, 2005b). Indeed, longitudinal epidemiological studies provide evidence that obesity, hypercholesterolemia, and hypertension track from childhood into adulthood and lifestyle choices such as diet and excess caloric intake influence these conditions (Gidding et al., 2005).

There is concern about long-term health as certain dietary patterns, developed in childhood and carried into adulthood, result in an increased risk for chronic diseases, such as obesity, heart disease, osteoporosis, and some types of cancer later in life. Some of the physiological processes that lead to diet-related chronic diseases have their onset during childhood. For example, studies indicate that the process of atherosclerosis begins in childhood (Gidding et al., 2005). Nutritional factors contribute significantly to the burden of preventable illnesses and premature deaths in the United States (DHHS, 2000). Four of the ten leading causes of death in adults are diet related: diabetes, coronary heart disease (CHD), certain cancers, and strokes. Diet is also associated with osteoporosis. Dietary factors also contribute to reproductive health, e.g., adequate consumption of folic acid to prevent neural tube defects in infants.

Dietary patterns are influenced by behavioral choices and environmental factors. It may be easier to change children’s health behavior than adults’ behavior. Childhood offers the opportunity to provide the solid foundation needed for healthful lifelong eating patterns. The importance of applying

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