Nutrition in Gigante Children

A common concern expressed by Gigante mothers is that their child has a poor appetite. Almost all of these children looked well nourished, but looks can be deceptive.

With this symptom, among other questions, I take a nutritional history and inquire what the child eats for breakfast, lunch, and supper, and how much water, milk, and juice the child drinks a day.

The typical story is rice and beans for breakfast, often with an egg or cheese, rice and beans for lunch, often with chicken or fish, and rice and beans for supper, sometimes with chicken or fish. There is usually a meat dish at least once a day. Plantains are another common carbohydrate. Water is the basic drink. Fruits and vegetables are not common and when I ask why, the response is usually because these food items are too expensive. There are trucks with loudspeakers that drive through Gigante every morning, and these trucks are the local vegetable suppliers.

So, the basic diet is rice and beans three times a day, one serving of egg, one serving of meat, and water or juice.   

I would like to plan a nutrition survey in Gigante. 

Bowes and Church's Food Values of Portions Commonly Used has been the standard reference for the nutritional content of foods in the United States and Canada for my entire career. I have several editions of this excellent reference book. Recently I sent the newest edition to both my adult daughters. So, I value this reference! 

Software is now available to assess the precise nutritional content down to essential amino acids and trace elements for the majority of foods. At the next visit I hope to host a growth and nutrition clinic. All children who attend will have a height, weight, head circumference (infants), calculated Body Mass Index, and nutritional survey based on a history of the child's typical diet and data from Bowes and Church's. 

The data collected will enable me to suggest changes for a child to achieve an optimal diet for growth and development. 

The survey will determine the "what goes in to the child" part of the nutrition equation. However, the "what goes out" part of the equation is also a consideration. 

Nutrition losses in the gut due to gastrointestinal illnesses are common in Nicaragua. Chronic or recurrent gastrointestinal infection with parasites, worms, bacteria, or viruses can undermine good nutritional intake. Parasitic and worm infestation should be considered in every child, even if they look well. Some medical authorities recommend routine treatment for parasites and worms annually, semi-annually, or even more frequently, even in the absence of symptoms. I treated about ten percent of the children for parasites based on history, exam, or maternal request.