Health promotion is defined by World Health Organization (WHO) as the process of enabling people to increase control over, and to improve, their health. Health is a positive concept emphasizing social and personal resources, as well as physical capacities (WHO, 1990). Healthy eating is defined as a diet reduced in fat and salt; or in starchy foods, fruits and vegetables. Here fruits and vegetables are mentioned to show the importance of fruits and vegetables has in our diet. Reflection within healthcare, is defined as the active process of reviewing, analyzing and evaluating experiences drawing upon theoretical concepts or previous learning, in order to inform future actions. This essay is a reflective to build an understanding about healthy eating of fruits and vegetables amongst children with learning disability within the age of 4 to 12 years, which can help in improving their health and well-being, and also the barriers that may be encountered along the process. A critical analysis and evaluation in which an area is chosen, by which it is planned to improve health promotion through the design of a resource to encourage children between the age of 4 to 12 years old, the importance of eating fruits and vegetables.
The early years of children are fully dependent on the caregiver or parents for their daily need which includes their food. As they grow older, their behavior starts to change towards making choice of what they want to eat, depending on what is available in the house, children may form a positive or negative habit of eating. Though, some of children may not fall under the category of those to be encouraged with fruits and vegetables, as people made up of different personality traits and cognitive development, which affect them as individuals. Similarly, other children, may have the perception of what they want or do not want. A study carried out on children within three age groups of 4 to 5 years, 7 to 8 years and 11 to 12 years, showed some behavioral changes as the children grow. A group of 4 to 5years old used the sense of seeing and touching to determine what they like. The other groups used taste to base their choice for fruits and vegetables. However, it was not about encouraging children to eat fruits and vegetables but their cognitive developmental changes.
Zeng et al. (2017) review of evidence shows significant and positive changes in language, learning, academic achievement, attention and working memory when children are engaged cognitively. For example, the choice they make for fruits and vegetables. Also, what type of fruits and vegetables the family consume, and the type that is readily available within the environment, might not be acceptable with their cultural belief and trying new foods, induces fear to them. Children at this age tend to grow rapidly, they therefore require higher amount of nutrients and vitamins at this period. However, Rosales et al. (2009) argued the role of nutrient in providing special functions to the brain such as choline, folic acid, iron, zinc etc. Although, it acknowledged the dearth of research in toddler years not only because of age-related variability, but because there has been a greater emphasis on measure of overall cognitive development like intelligent quotient (IQ), which is difficult to assess until elementary school years. Also, promoting different colors of fruits and vegetables, signify unique nutrients and vitamins that when combined with each other, produce the required protection the body needs for good health and well-being. For example, orange and red colored fruits and vegetables are rich in vitamin A, beta carotene and antioxidant, which is necessary for good sight and prevent cell damage, while the green colors provide vitamin K, calcium for strong bones.
However, due to emphasis laid on fruits and vegetables as a healthy food has made some children to interest in its consumption. Though, high intake of fruits and vegetables is still believed to reduce the risk of suffering from major chronic diseases, for instance, diabetics, hypertension, kidney failure. In addition, the health condition of children with learning disabilities might have an impact on their eating habit, such as communication, dysphagia, food texture preferences, hypothyroidism, large tongue, slow oral motor development, acid reflux, celiac disease, picky-eating, weight gain, lower body metabolism, allergic reaction. However, other factors do affect people with learning disabilities and expose them to become underweight and under nourished which result from eating less or poor food intake, short feeding time, not considering the nutritional needs of the individual, children with swallowing difficulties or long period without eating after epileptic seizures.
The recommended five or more portions of different fruits and vegetables a day by World Health Organization (WHO), has associated eating food rich with fruits and vegetables to prevent or reduce different types of diseases and certain cancers, cardiovascular disease, hypertension, etc. It went on to say that when children consume fruits and vegetables earlier, it might help to prevent certain co-morbidity in the future when they grow up. For example, early management of diabetes with adequate consumption of fruits and vegetables might lead to delay in cataract development in future, encourage normal bowel function, with good bowel opening (John et al., 2002; Taylor et al., 1995; Cox et al., 1998).
Evidently, studies had found increase in population of obese children in high-income countries, resulting from eating highly processed food, conversely, Rico-Campa (2019) found out that a higher consumption of ultra-processed food is associated with 62% in relative increased hazard for all-cause mortality. More so, WHO confirmed this and has recommended fruits and veg and high fiber diet from whole grain cereals to help reduce obesity which could result to increase mortality. Although, the reason for encouraging high intake of fruits and vegetables still is a preventive measure to protect people against preventable disease that may increase mortality in future.
Healthy eating can help control the energy required in the body to build a healthy mind. This will stabilize the mood, maintain healthy body weight, prevent anxiety, attention deficit hyperactivity disorder (ADHD), reduce risk of depression and other mental health problems (Liu et al., 2016). Understanding and encouragement in eating of healthy food from childhood will become a good habit that can be taken to adulthood. A study published in 2017, discovered beverage made with wild blueberries promotes positive mood in children and adolescents (Khalid et al., 2017).
However, most children with learning disability have difficulty in understanding being healthy or what healthy diet means. In this effect, there should be reasonable adjustment within educational and health services, to provide information from this age group 4 to 12 years. So that these children will start early in life to receive information that will promote a healthy lifestyle. Being creative with fruits and vegetables. For example, creating a scene on the plate, to bring in fun while enjoying the meal using broccoli as trees, place cauliflower as cloud and other bits to look amazing. In addition, frequent eating of fruits and vegetables might help to reduce hypertension, help bowel function. There is a need to prevent barriers in engaging physical activities as a result of disability in children, so there is need to introduce the additional support for parents or carers to help meet the needs of the children. Reasonable adjustment according to individual need to help manage and improve eating pattern. This will help the child to start developing interest and be motivated to perform such activities.
To develop good eating habit is one of the requirements for children to learn about healthy lifestyle which includes healthy diet. Children should be involved early in life to experiment and be exposed to varieties of food, fruits and vegetables, also to taste, feel the texture, smell and see the different colors.
Facilitation is defined as the provision of opportunities, resources, encouragement and support for the group to succeed in achieving its objectives and to do this through enabling the group to take control and responsibility for the way they proceed ( Bently, 2018). With this definition in mind, poster presentation and activity playing will be discussed to support the use of the resource.
Poster presentation and easy read can be used to demonstrate how the body makes use of the fruits and vegetables eaten. Playing different activities allows information to be delivered in different ways so that children with learning disabilities can understand at their individual levels. Activities help in socializing, people coming together to participate, being part of the game, brings one closer to the product thereby allay phobia for that product and improve confidence. Additionally, selecting any fruit or vegetables of choice makes the child feel better than when it is handed over to the child. Regular exercises either outdoor or indoors help to manage weight, improve the child’s mood, alertness and appetite. The child should be involved in the care or exercise. A diet plan and using children's weight measurements to monitor intake will help ensure children are eating healthily and abnormalities are detected early.
Certain health conditions affect children with learning disabilities from eating healthy, such as cerebral palsy which makes it difficult to eat leading to underweight. Others lack physical activities and difficulties in swallowing (dysphagia), and some that refused to eat or drink for no reason are referred to multidisciplinary team (MDT), such as general practitioner, speech and language therapist, child psychiatrist, child psychologist, occupational therapist, developmental pediatrician and social worker for proper assessment and management. Behaviors displayed by children with learning disability might be a clue to help discover underlying illness. For example, some eating disorder such as difficulty in chewing, playing with food at mealtime instead of eating, might be due to developmental, neurological, behavioral or medical problems. MDT will work within their expertise to manage such children, parents and the care giver are trained and involved their care. The MDT and all the staff maintain confidentiality. They MDT will create strategies that will be applied during mealtimes.