Interestingly, it’s not only the colour of our hair and our eyes that is established before we’re born; children have a genetic predisposition to prefer certain tastes (the fact that some children prefer meat pie and sauce to seafood risotto might, therefore, be blamed on what took the fancy of their grandparents!) Nevertheless, the main influence on a young child’s eating behaviours and food choices are their parents and care-givers. We adults must set the example. We can help children to establish healthy eating habits that are carried into adulthood.

However, older children and adolescents are also subject to many other influences on their eating habits. These include peer pressure and, not surprisingly, television. Several studies have shown rates of overweight and obesity in children related to hours of TV viewing (a recent study has also shown increased death rates from all causes in adults watching more than four hours of TV daily – these deaths being apparently linked to lack of mobility). Obese children have a significantly higher risk of becoming obese adults with all the associated health risks.

Soft drinks, vitamin drinks and energy drinks have all become fashionable. Consumption of such drinks is a fashion that should not be allowed to extend to children.

Up to the age of 12 months, breast milk, infant formulas and water are the only fluids recommended. From 12 months onwards, cows’ milk is an important source of calcium, protein and some B group vitamins for children and adolescents; and the trend toward the greater consumption of soft drinks, instead of milk, is fraught with danger. Cola drinks seem to present particular problems.

In the United States, the consumption of cola beverages has been associated with bone fractures in physically active high school girls, possibly due to the high phosphoric acid content in cola drinks. In addition, caffeine increases the rate of elimination of calcium from the body. Similarly, energy drinks are considered unsuitable for children, mainly because of their caffeine content.

As with drinks, so with food; fashion and fad diets might be commonplace with adults, but have no place with young children. A child on a vegetarian diet is at risk of a number of nutrient deficiencies. So, such a diet for a child must be carefully planned; while a strict vegan diet is not recommended at all.

As well, there are a number of specific foods which are considered unsuitable for children under the age of five – foods such as nuts, lollies, popcorn and pieces of raw vegetables and raw apple.

Of course poor food choices can occur as we get older as well. It would seem most unlikely that anyone in Australia could be malnourished; and yet malnutrition among older people is quite common; and it’s a condition that often goes unnoticed.

Elderly men seem to be more at risk than elderly women (men living alone are less likely to eat regular well-balanced meals), but some risk factors affect both men and women. Gastro-intestinal symptoms such as heartburn, indigestion, constipation, vomiting and diarrhoea might be obvious. Perhaps less obvious are conditions such as arthritis, difficulty in swallowing, poor fitting dentures, dry mouth, oral infections and medication side effects.

If you are caring for a child or may be an older person, and you’d like some nutrition advice, call into one of the 2000 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information – they have a series of fact cards on nutrition. For the nearest location, go to the Pharmaceutical Society website at www.psa.org.au and click on “Self Care Pharmacy Finder” or phone 1300 369 772.

©2010 Pharmaceutical Society of Australia

It’s a risky process and can only be undertaken under medical supervision.

Of course nuts are not the only source of adverse reactions to foods. Perhaps less spectacular, but certainly more common, is the reaction to certain cereals – specifically cereals containing the protein gluten.

If you are sensitive to gluten, you’re deemed to have coeliac (pronounced see-lee-ak) disease; and you’re likely to experience such symptoms as bloating, diarrhoea, nausea, wind and chronic fatigue.

Stomach cramp or pain and constipation sometimes occur. Children with coeliac disease fail to thrive; adults are more susceptible to mouth ulcers and osteoporosis. Unexplained weight loss, hair loss, skin problems, even infertility and recurrent miscarriages can result from coeliac disease.

Sometimes symptoms are very vague and may be confused with irritable bowel syndrome (IBS) or simply wheat intolerance; sometimes symptoms may be put down to stress or just getting older.

The cause of coeliac disease is not fully understood; but it seems that people with this condition may be born with an enzyme deficiency so causing abnormal breakdown of gluten and a build-up of a toxic substance. Gluten is the protein found in wheat and rye and to a lesser extent in oats and barley. It is often present in bread, cakes, biscuits, pasta, pizzas and many processed foods – meats, soups, sauces and so on. Another theory on the cause of coeliac disease is that the immune system over-reacts to the “foreign” protein.

Whatever the cause, the result can be disastrous. Damage to the intestine leads to deficiencies in vitamins, iron, folic acid and calcium because of the poor absorption of nutrients. Sugars, proteins and fats are poorly absorbed as well. In some very severe cases coeliac disease can be fatal.

Each year, National Coeliac Awareness Week (13-20 March) highlights the need for us to consider coeliac disease when “stomach problems” persist. Despite the markedly varying symptoms and sometimes their extreme severity, treatment is usually simple and effective.

Early diagnosis of coeliac disease is important. (Evidence suggests that only 1 person in 5 with coeliac disease has had the condition diagnosed.) However, the good news is that, once diagnosed, the treatment for coeliac disease is extremely successful. It very simply involves strict adherence to a gluten-free diet.

This might sound difficult but it’s well worth the challenge of finding gluten-free foods on the supermarket shelves. Once started on a gluten-free diet, coeliac disease sufferers will pick up quickly and regain their energy and good health.

Be aware, however, that a gluten free diet is not a fad diet; certainly not for the more than 200,000 Australians who suffer with these gluten triggered symptoms. And a gluten free diet should not be started before the appropriate blood screening or other tests your doctor can order. Otherwise diagnosis may prove difficult or inconclusive.

Your local Coeliac Society or the web site www.coeliac.org.au can provide more information. They have dietary advice, recipes, information on where to buy gluten-free food, and above all the support needed to achieve effective control over the condition.

You can also get advice about intestinal and bowel problems from pharmacies providing the Pharmaceutical Society’s Self Care health information. Call 1300 369 772, or check out the Pharmaceutical Society website at www.psa.org.au, for the nearest location. There are fact cards on Heartburn and Indigestion, Vomiting and Diarrhoea, Constipation and Irritable Bowel Syndrome.

©2009 Pharmaceutical Society of Australia

However, to retain his peak fitness levels, Popeye would almost certainly have had to consume a regular portion of lean red meat as well. There’s no doubt spinach has great nutritional value; but to get our recommended intake of iron just from spinach, we’d be needing upwards of half a kilo a day. There wouldn’t be much room on the plate for anything else.

While we’re not really sure how Popeye became so strong and muscular, we do know that he definitely needed iron in his diet. We all do. And there’s a fair chance we may not be getting enough.

Iron deficiency is common. In fact, it’s the most common nutritional deficiency in the world, affecting about a third of the world’s population. Earlier this year a University of Adelaide researcher, Dr Alex Johnson, was awarded a grant of nearly $300,000 to work with the Gates Foundation-funded Harvest Plus Challenge Program to try to increase the iron content of rice and other cereal grains.

Rice and wheat are the two most widely consumed cereals in developing countries and most of the iron content is lost in the milling process. In the western world the problem can be overcome by adding various compounds to flour to make it rich in iron; but poorer nations can’t afford this luxury.

Nevertheless, despite enrichment of bread and cereals in Australia, iron deficiency is considered a major health issue here. Women are particularly at risk with some studies indicating that only 25% of women receive the recommended daily intake of iron through their diet.

Menstruation, pregnancy and breastfeeding all increase the need for iron. Babies, toddlers and teenage girls need extra iron too; as do athletes, especially female athletes – this is because regular exercise and hard training increase the production of red blood cells (iron is required for effective function of red blood cells) and iron is lost through sweating.

Vegetarians and people on fad diets may also be at risk of iron deficiency.

Iron is an essential component of many enzymes involved with important chemical reactions in the body. It’s also a component of haemoglobin which is responsible for the transport of oxygen through the blood stream.

So, no iron, no energy. Other symptoms of low iron levels include general tiredness, irritability, poor concentration, shortness of breath, dizziness and headache. Significant iron depletion can also lead to poor immunity and, therefore, increased infections.

There are two types of iron from dietary sources. So-called haem iron comes from animal products, primarily red meat, but chicken and fish also provide haem iron. This form of iron is easier for our bodies to absorb. Non-haem iron comes mainly from plant foods – bread, cereals, fruit and vegetables. Tomatoes, broccoli, pumpkin and cabbage may actually be a better source than spinach. Non-haem iron is poorly absorbed, however, absorption is enhanced by vitamin C; so a glass of orange juice with your iron-fortified breakfast cereal makes good sense.

On the other hand some foods actually hinder the absorption of iron. Tannin (in tea or coffee) reduces the absorption of iron as do antacids and aspirin. Other minerals such as calcium and zinc can also interfere with the absorption of iron.

If you suspect you could be deficient in iron, check with your doctor or pharmacist. A simple blood test can confirm the status of your iron levels.

If iron levels are low and dietary changes are not sufficient to rectify the problem, an appropriate supplement can be recommended. Remember, iron in overdose can be toxic; so keep iron tablets out of the reach of children. Nicely coloured tablets can be easily mistaken for lollies. Also, iron can accumulate in the body if iron therapy is given in excessive amounts for too long. We should avoid becoming a life size fridge magnet from iron overload.

You can get more general advice on diet and health, and iron deficiency in particular, from pharmacies around Australia providing the Self Care health information. Phone the Pharmaceutical Society on 1300 369 772 for the nearest location and ask for the Nutrition series of fact cards.

©2008 Pharmaceutical Society of Australia