The Health and Nutrition of the School Children Through a Holistic Approach - Research Paper Example

It was in mid-80s when public health movement was started around the globe to assess the progress on the achievement on the objectives of Primary Health Care declaration of Alma Alta. In 1986, first international conference on Health Promotion was organized in Ottawa, Canada (Ref). This was the first international gathering where the term and concept health promotion was promoted. It was decided that to achieve the level of health defined by World Health Organization (WHO) (ref) a comprehensive guideline or process should be there to help moving in the direction of achieving that level of health. So health promotion was described as the process, which enables the people or individual to increase their control, over their health, and to improve their health. This conference provided the forum to discuss and establish the means and ways of working for health promotion and thence to develop the strategies of health promotion. In fact health promotion strategies and programs are needs based; they may be different for different countries because of the local needs as well as the unique cultural and economic systems (Ref- Ottawa, http://www.who.int/healthpromotion/en/). Actually, in this conference it was optimized that Health for All by 2000 (HFA 2000) could be possible through the successful implementation of health promotion strategies at national and regional levels (Ref). WHO (http://www.who.int/school_youth_health/facts/en/index.html) has prepared a fact sheet regarding the situation of status of health of the students as well as the environment prevailing in these schools which may influence the practices of the students towards a positive or negative direction as far as the healthy and education of the students are concerned. Worm infections are the greatest cause of disease among 5-14 year old children. Vitamin A deficiency is the single greatest cause of preventable childhood blindness. Iodine deficiency is the single most common preventable cause of mental retardation and brain damage in children. Injury is the leading cause of death and disability among school-age youth. One out of two young people who start and continue to smoke will be killed by tobacco-related illness. Worldwide, 5% of all deaths of young people between the ages of 15 and 29 are attributable to alcohol use. In some countries, up to 60% of all new HIV infections occur among 15-24 year olds. Role of nutrition in learning and cognition starts even before the birth of child. If there is hypoplasia or deficiency of Iodine in the diet of pregnant woman, her newborn will be born with hypothyroidism. If the situation is not corrected with appropriate supplement along with regular feed even in early neonatal period the child cognition may be affected which in turn leads to all type of deficient learning, poor alertness and behavioral changes (Ref). The last trimester and some time beyond neonatal period (about two months) are critical because during these weeks the development of brain in its full swing and a greater part of this over all growth is completed by this time. Of course a simultaneous process of physical growth is also on progress (Ref). During this time the newborn is totally dependant on his / her mother’s condition. Her health and nutrition status before conception, the chain of events during pregnancy, nutritional increments during pregnancy, and any acute but severe or prolonged illness, all have their own effect on the health of mother, the progress of pregnancy and eventually the status of fetus and pregnancy outcome. Once the newborn has started feeding, he or she again is dependant on the mother’s health and nutrition status even if on breastfeeding or not. Because mother’s role in the over all upbringing and growth of the newborn and further child in later period cannot be ignored. Vitamins and trace minerals have got important role in the required for production of various enzymes, hormones and biochemical mediators which in turn regulate various biological processes. These processes are either required for energy production, synthesis of RNA and DNA and or for providing protection against reactive oxygen-free radicals. These micronutrients are essential components for promotion of physical growth, sexual maturation and neuromotor development. Additionally, a variety of vitamins (vitamins A, E, C, D, B2, B6, folic acid etc) and some trace minerals (iron, zinc, selenium, copper) have also been important in the defense of the body, both cell-mediated and humoral immunity. Naturally, whenever there is imbalanced nutrition or there is increased demand due to repeated infections these micronutrients eventually become deficient and end up in the growth retardation. [Ref ]. This turns out as a vicious cycle as there is dietary inadequacy which leads to recurrent infections which in turn lead to again further deficiency in diet and thus the process ends up in crucial way unless this cycle is interrupted before a critical point reaches. Therefore, it is more logical not to reach to this point, which can be achieved by proper nutritional contents in the diet of the infants and further on preschoolers. It is a well-established fact that different micronutrients have got strong metabolic inter-relationships. As ascorbic acid facilitates the absorption of non-haem iron while the absorption of iron and copper is very much influenced by intake of zinc in higher quantities. This strong interaction has been utilized in Wilson's disease to reduce copper load by taking excessive amounts of zinc (>50 mg/d). [Ref] While Vitamin A is important as far as iron transport, hemoglobin production and improvement of the status of iron stores which in turn is affected by the deficiency of Zinc as Zinc deficiency aggravates hypovitaminosis A especially at the target tissue level when this deficiency hampers liver to tissue transport route of vitamin A. Interestingly, Vitamin E protects vitamin A from oxidation. Bone is an important tissue, which not only protects various vital organs like brain, lungs and heart or provides site for muscle attachment but they are also involved in other very important tasks in the body as well, which includes production of blood and the storage site for marrow. Another important function is the participation in the regulation of minerals and calcium and phosphorus. Calcium and phosphorus along with some vitamins for example vitamins A, C, D and K are required to maintain the integrity and mineralization of bones. Among various micronutrients, the role of zinc has been widely studied in experimental animals and human beings. Zinc is a constituent of over 200 metallo enzymes and is involved in a large number of biological processes [Ref]. Brain Development Contrary to the general concepts, basic units of the nervous system, neuron, is more sensitive to nutrients and dietary chemicals than the other body cells. So, the developing brain is a vital target with high demands of various nutritional components. This process of brain development starts in the pregnancy and actively continues in the early years of infant life, when the child is in his / her preschool age. Hence, an optimal nutrition during pregnancy and first years of life is most crucial to meet the demands of the developing brain. There are multiple metabolic pathways going on at various parts of the nervous system. These pathways depend upon a variety of enzymes and coenzymes and these catalyzing structures in turn are highly dependent on micronutrients for their production. For example, vitamin B-complex as: B1,B2,B6,B12 and folic acid are important ingredients for the synthesis of a number of neurotransmitters (Ref ). Vitamins B6, B12 and folate and choline play an important role in the regulation of plasma levels of homocysteine; there deficiency may result in thromboembolism eventually ending up in stroke. While iodine is essential for the synthesis of tri-iodothyronine and thyroxin and iron is utilized in the synthesis of dopamine, serotonin and GABA which are important compounds for the functioning of neurotransmission system.[14],[15] Fish and fish oils are important sources of omega-3 fatty acids and decosahexaenoic acid (DHA). Omega-3 fatty acids are important component which reduce the endothelial inflammation and specifically involved in the process of reducing cellular and vascular inflammation in the brain, also help in promoting vasodilatation and this way ensure integrity of brain cell membranes to keep them in a more flexible, soft and pliable form.[Ref] On the other hand, DHA is an integral component of the group of compounds, which contribute to the building material for the synthesis of synaptic communications, and interestingly they represent almost one-half of the total fat in the brain cell membrane. It increases the level of serotonin, which has got an important role in mood elevation and chemical acetylcholine is an important as far as the enhancement and improvement in the memory is concerned. Zinc is a component of a large number of metalloenzymes and there is high concentration of zinc in the brain. Copper is an important component of cytochrome-C oxidase and superoxide dismutase in the brain. It has been well known that pellagra (niacin deficiency) leads to reduced cognition and dementia. The brain-friendly nutrients are listed in [Ref]. Focusing Resources on Effective School Health (FRESH) In 2000, at the World Education Forum in Dakar an interagency initiative was launched with the name of FRESH, which stands for Focusing resources on effective School Health. The collaborating agencies are: UNESCO, UNICEF, WHO and World Bank. This united effort was proposed to strengthen the view of addressing the issues related to the health and nutrition of the school children through a holistic approach utilizing the multiple strategies in contrast to the individual efforts put in by the these agencies through separate programmes. This initiative had been started after the common experiences, which suggested towards a concerted action by the partnership of these agencies so that the scope of school health programmes could be broadened and made them more effective. It I s expected that the effective school health programmes will be instrumental to the progress of child-friendly schools and eventually lead to the promotion of education for all. This initiative will be focused to help in implementing a core group of activities, which has got support from these partner agencies; the beneficial things is that it captures the best practices from programme experiences. The inherent advantage of being specific and interagency agenda there are chances that this effort will result in motivating other countries to work on these lines for the betterment of their school children and put in maximum efforts to make these programmes a success. In fact this initiative is like a pretesting phase and will be followed by addition of more activities, which are suitable and practical to carry out. Schools in Scotland are working on the agenda of health promoting school but yet have not achieved the full targetr of completed activities; they have agreed to convert schools to health promoting schools by year 2007. This would be based on a holistic approach through which the physical, social, spiritual, mental and emotional wellbeing of the teachers and students will be improved and promoted. At the moment when schools in Scotland are implementing FRESH initiative, it seems appropriate to have a formal review of the efforts made in this regard. This will help in: Assessing the level and degree of implementation; Assessing the quality of implementation; Assessing the achievements made; Assessing any problems appearing during implementation; Assessing for any change needed in the implementation process. Read More