Welcome to our podcast show, where we explore the world of pediatrics and child health. In this episode, we are thrilled to have Dr. Tresa Chakkalakal, a board-certified pediatrician with extensive experience in providing quality care for children and their families. Dr. Tresa is here to share her expertise on childhood nutrition and provide insight on recommended dietary guidelines for infants and children at different stages of development.. It is essential for parents to understand the importance of providing their children with a balanced diet that meets their nutritional needs to support healthy growth and development.

About the Guest:

Dr. Tresa Chakkalakal is a pediatrician, aka “the kid’s doctor”. She is very outgoing and welcomes her patients to call her “Dr. Tresa”. Dr. Tresa originally trained in obstetrics and gynecology in India. After moving to the United States, she obtained her M.D., became Board Certified by the American Academy of Pediatrics, and started her medical practice in New York. In addition to the clinical practice there, Dr. Tresa was also Chief of House Staff for the Department of Pediatrics at the Brookdale University Hospital Medical Center.

About the Hosts:

Angelina Huang, Founder

Angelia is a nationally top ranked junior golfer at her junior high year. Angelina is also ranked number one academically among seven hundred students at Clark High School, Nevada. Angelina hopes to play college golf and pursue a career in the medical field or dentistry. Her passion is Neuroscience and Statistics. Angelina has been travelling around the country competing against the best junior golfers in the world since age of seven. She is also the Amazon published author, “I Want to Play College Golf”. Since Year 2021, Angelina and Cameron have donated over $17,000 their book proceeds back to the community for the underserved family and patients who are in need of cancer treatment. Aside from daily golf practices and school, she enjoys listening to music and watching chilling crime shows.

Cameron Huang, Founder

Cameron is also a nationally top ranked junior golfer at her sophomore year. Cameron is ranked top 5% academically among eight hundred students at Clark High School, Nevada. Cameron also hopes to play college golf and pursue a career as an orthodontist in the future.  Cameron is the coauthor of “I Want to Play College Golf” with Angelina, and they have donated over $17,000 their book proceeds back to the community for the underserved family and patients who are in need of cancer treatment.  When Cameron isn't on the green or studying, she's enjoying her free time watching K-drama and studying makeup and skincare with her friends.

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Welcome to the Dentistry For Kids podcast where Angelina and Cameron and we love candy. Do you all love candy? We've learned how to enjoy all the candy we want without getting cavities or getting in trouble with our dentist wants to learn our magic. Join us discover how to enjoy sweets and have nice bright clean shiny white tea. Let's go.

Doctor Tresa is a pediatrician also known as the kids doctor. She's very outgoing and welcomes her patients to go her doctor Tresa. Doctor Tresa originally trained in obstetrics and gynecology in India. After moving to the United States, she obtained her MD became board certified by the American Academy of Pediatrics, and started her medical practice in New York. In addition to the clinical practice there, Dr. Tresa was also chief of house staff for the Department of Pediatrics at the Brookdale University Hospital Medical Center. So our first question today is, what are the recommended dietary guidelines for infants and children at different stages of development?

Hi, everyone. Hi, Cameron. So yes, I'm really it's a pleasure for me to talk to you today about the dietary requirements in general about children and their health requirements. So beginning with the dietary aspect, obviously, with babies and infants, you know, primarily their own breast milk and formula. So in the beginning, that is the key or dietary intake for them. And it's usually about 24 to 30 ounces of either breast milk or formula up to about six months of age. After that, we're going to introduce of course various types of cereals, vegetables, fruits and proteins, and usually as purees.

And then eventually into bite sized pieces. Now, after one however, once they're toddlers, things are going to change. Now we're introducing them to real adult food. So they got to learn to feed themselves independently, you know, they do start to show some signs of pickiness. So it's very important to introduce them to family meals. And as they go into preschool, they're going to be influenced by their friends in school and other kids around them. So it's still very important to sit as a family and feed them or rather let them eat with you guys, everybody eats his family, this has shown to, you know, provide better health outcomes to all kids. Now, of course, school aged children are influenced by friends, school media, a lot of different things. So again, we have to balance these negative influences they may have with positive influences from the home. So always, it's important for us to provide even four to seven meals a day to children between three main meals and snacks. So it seems like a lot, but that is important. And they have to be a well balanced diet, nutrient rich foods and portion sizes. Very important.

Perfect. So the next question is how much protein carbohydrates and fat do infants and children need for proper growth and development.

So as you know, Cameron, our kids are growing, so their requirements are going to vary depending on their age. So in general, a general rule would be that most all children need about 45 to 65% of their calories from carbohydrates. And that would mean you know, rice, or cereals, oatmeal, breads, things, pasta, things like that. And the recommendation is that at least half of this should preferably come from whole grains. They are the healthy types of carbohydrates. Fats, on the other hand, is about for young kids below two, there's no restrictions, fats are very essential. So they need to eat fats for the growth of their brain for their eyes, now above to and they need about 30 to 40% of their calories from fats and off which less than 10% should be saturated fats. And then above h4, we say about 25 to 30% of their total calories come from fats and fats would mean various kinds of butters marjorine oils, olive oil, you know things like that. Then proteins. Proteins, of course, as we know are essential for growth of their muscles every part of the body in fact, so about ranges between 10 to 30% of their calories daily calories come from proteins, and this comes mainly from milk or milk supplements. In children, fish, poultry, eggs, beans, legumes, tofu, things like that. And then we go to the other ingredients like vegetables, which are, you know, important, a good variety of different colored vegetables are needed. And then fruits, whole fruits are preferred to fruit juices. So this is a rough gist of the types or the amount of the main basic food groups.

Okay, okay. So are there any specific nutrients that are important for children's brain development?

Yes, as I said earlier, fats below h2, they need their full support supply of fats, mainly from healthy fats, you know, like, their milk, from powders from fish, poultry. So these fats are needed for the growth of their brain. They also need proteins because there's proteins in the brain, so they need that zinc, iron, and vitamins like A D, and B six, and B 12. All these unnecessary for their brain development.

So what are the best sources of nutrients such as iron, calcium and other minerals?

Right? So yes, as we know, kids are growing. So they need a lot of these nutrients, especially calcium and iron. And these are very, very important parts of their daily intake. Now, calcium, of course, you know, the quantity varies, and when they're younger, they don't need as much but as they get into their adolescent age, they need a lot more. Mostly calcium comes from dairy, or dairy supplements like milk, soy supplements. And there are a lot of vegetables and fruits that are rich in calcium actually, things like beans, broccoli, rhubarb, bok choy, Chinese greens, kale, spinach, these are all very good in calcium. And the same with iron, iron rich foods and catch calcium rich fruits are pretty similar. As we know iron is there in meats, beans, legumes, all the dark green leafy vegetables, and also dark chocolate that kids would love that. And then dried fruit, dried fruit is a very good source of iron. So these are important.

Interesting. So what are the consequences of not getting enough vitamins and minerals in a children's diet?

Right. So every ingredient has a certain function in our body, right, especially as the kids are growing. So things like calcium, minerals, like calcium, as you know, is very, very important for growth of bones. So bone and brain calcium is an important part of muscles, literally our muscles function on the on calcium. So deficiency of calcium can affect bone growth, they end up with a disease called rickets. If calcium is very low due to, in fact a deficiency of vitamin D. And then iron deficiency leads to a condition called anemia, where they do not have enough capacity to transport oxygen in their blood. So they tend to look pale, they start to feel weak, tired, Dizzy, easily fatigued. So these are signs of iron deficiency. And other minerals too, like zinc, and phosphorus, magnesium, which come from all these similar sources can affect their, you know, energy levels, their bare strength of their bones and muscles.

And can a vegetarian or vegan diet meet the nutritional needs of growing children?

Yes, more and more people and families actually have been, you know, adopting the vegetarian diets? Um, yes, there are some pros and cons. The pros are that yes, it's a healthier diet overall, because, you know, you're not exposed to a lot of the red meats and a lot of those substances which fats which are considered to be harmful. But the the cons would be that it is sometimes hard to get all the nutrients you need from a pure vegetarian or a vegan diet, especially nutrients like proteins, and vitamins like vitamin B 12, which is found mainly in mostly animal products. So it can be still considered a healthy diet as long as we are aware that these nutrients are deficient and we're making sure that the child is getting those are getting supplements of those nutrients like in the form of an enriched cereal, it could be vitamin D or vitamin B 12 enriched milk, or they can actually do oral supplements in the form of vitamin B 12, you know, vitamin capsules or chewables. And so, as long as they're aware of these are deficient sees it can still be made into a pretty well balanced vegetarian diet.

And so this next question is going to be a two part question. Yeah. So the first part is, how does a child's diet impact their energy levels, sleep patterns and mood? And the second part is, in a child's diet impact their attention span and ability to focus.

Yes, definitely Cameron, because energy levels directly are related to what we eat. So, yes, there are many different aspects of our diet that can affect our energy levels, our sleep patterns. And the same with children. So as you know, high sugar diets can cause mood swings, for sure, we've seen that in children it studies have shown their energy levels can skyrocket and then drop. So it can lead to a sudden drop in energy, and can cause severe changes in their significant changes in their moods. And this, in turn, can disrupt their sleep patterns. So it's very important for parents to be aware of to control the amount of these high sugar intake in their daily diet of their children. And then the second part I think you asked is about the attention and focus. Yes, for sure. As we said, studies have shown unhealthy diets like high, high quantities of sugars, high quantities of actually colored foods, the very bright colored drinks, or bright colored candies, which have various additives and coloring agents to them, actually have shown an increase in the incidence of attention deficit in children, focusing issues and children behavioral problems in children. So these are some things that parents can keep an eye out for, as they, you know, provide snacks to their kids.

And so our last question is, how much water does a child need? And around what age they start drinking this amount of water?

Right? So water, yes, it's a very essential part for our overall health. In terms of infants, for the first six months, they don't need a lot of water, because breast milk and formula both have water in it. But once they start solid food, yes, intake of water is essential, which could range at that age, as infants from a couple answers with every meal is usually sufficient. Now after age one, a simple rule to remember in terms of the amount of water intake would be about one cup of water per H, one cup is actually about eight ounces of water, which is 240 milliliters. So for a one year old, you want to make sure this is a minimum requirement. So one cup of water for a two year old will need two cups of water, a three year old will need three. So age nine and up, they need at least eight to nine cups of water a day. And each cup is eight ounces. So that's quite a lot of water. And this is for basic daily activity. Now, if the child is doing sports, or it's extra hot, whether you're outside in the park, oh, yes, you need additional quantities of water every day. Can you cook that emphasis the amount? Yes, you did. Perfect.

And so do you have any final words with your audience?

Yes, yes, we all want the best for our children. Yes, as a mom and as a pediatrician. That's definitely you know, something that's on the forefront of my mind. And I'm sure your minds too, that you want to provide a healthy, nutritious diet to your child. At the same time, I would say let them be children, they are allowed to have a few little treats here and there. You know, as long as there is a control, there is a limit to that, you know, and for the most part, you're inculcating those good habits of eating together as a family, not just the habits of eating healthy. But even that sense of being together, sharing food, talking at the table. These things are also important aspects of a meal together. So we have to look at it from all these aspects and it's okay to give them a little dessert treat at the end of the meal. Once a day, that's okay. As long as they know they need to brush their teeth after that. Right.

That's about it. So thank you so much for joining me here today.

Of course, it was a pleasure, Cameron. Thanks for having me.

Have a nice day.

You too.