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The Essential Nutrition Guide for Children

Pediatric Consultant Dietitian for Healthcare facilities

Nutrition during the childhood years sets the foundation for the future. What children learn about food can impact their eating habits and preferences, weight, and health status later in adulthood. With childhood obesity rates continuously increasing, the importance of nutrition is even more prevalent. Whether a child is one years old, ten years old, going through a growth spurt, or being active in sports, the importance of eating a nutrient-dense diet is widespread.

Balancing a Variety of Food Groups

Consuming a variety of food groups each day allows a child to obtain several different nutrients that are necessary for proper growth and development. In addition, eating a variety of food groups helps prevent boredom and trains the palate to like different foods.

Below are the five main food groups to focus on:

Protein – sources such as eggs, chicken, turkey, Greek yogurt, cottage cheese, and natural peanut butter are critical for tissue repair, and bone, muscle, and cellular development. Protein also supports the immune system and promotes a healthy metabolism. A child should eat a source of protein at all meals and snacks.

Vegetables and Fruit – provides an abundance of nutrients including fiber, Vitamin C, and antioxidants. Sources such as broccoli, bananas, apples, carrots and leafy greens are packed with vitamins and minerals that children need to stay healthy. It is recommended for children to have a vegetable or fruit at every meal and snack.

Healthy fats – are necessary for a child’s brain development, hormone production, nutrient absorption, and satiety. Incorporate a tablespoon of healthy fats at meals to help increase nutrient absorption and fullness. Below is a list of sources of healthy fats to incorporate into the diet:

  • Monounsaturated fats: avocados, olive oil, nuts, and seeds

  • Polyunsaturated fats: flaxseed, walnuts, and fatty fish such as salmon, herring, mackerel, and sardines

Dairy – Dairy is comprised of a variety of nutrients including calcium, vitamin D, phosphorus, magnesium, and potassium. Sources such as Greek yogurt, cottage cheese, milk, and cheese are great options. Children should consume 2-3 servings of dairy each day.

Whole Grains – Whole-grain foods contain all 3 elements of the grain; the bran (the outer portion), the endosperm (the inner portion), and the germ (the heart of the grain). When incorporating grains into the diet, look for “whole grain” as the first ingredient on the ingredient list, and aim for sprouted varieties when possible. Sources of whole grains include brown rice, quinoa, barley, and oatmeal.

Important Nutrients during Childhood

Iron:

Why it’s important: Iron is a mineral that carries oxygen in the blood and helps increase energy. It also helps promote healthy skin, hair, and nails. Children’s diets are often low in iron so it’s important to be mindful about getting adequate amounts.

Sources: meat, eggs, dark leafy greens, beans, and dried fruit

Helpful Tips: Take iron-rich foods with Vitamin C to help increase absorption. Avoid taking iron-rich foods with dairy because calcium blocks iron absorption.

Children ages 1-3 need 7 mg of iron/day

Children ages 4-8 need 10 mg iron/day

Children ages 9-13 need 8 mg iron/day (1)

Zinc:

Why it’s important: Zinc is a mineral that is found in all tissues and helps with growth, skin health, immunity, hormone production, and digestion.

Sources: red meat, poultry, oysters, beans, nuts and seeds

Helpful Tips:

Children ages 1-3 need 3 mg of zinc/day

Children ages 4-8 need 5 mg zinc/day

Children ages 9-13 need 8 mg zinc/day (2)

Vitamin D:

Why it’s important: Vitamin D is crucial for the absorption of calcium and aids in keeping bones and muscles healthy. It also plays a role in moods, nutrient absorption, metabolism, blood sugar, and immune system. In addition, some studies have found Vitamin D to play a role in cancer protection (3).

Sources: sunlight, salmon, tuna, egg yolks, fortified dairy products, cheese

Helpful Tips:

Vitamin D levels should be between 30-80 ng/mL The Recommended Dietary Allowance (RDA for children ages 1+ is 600 IU/day. Children under the age of 1 need 400 IU/day (2).

Calcium:

Why it’s important: Calcium helps make bones strong, supports muscle contractions, transmits messages to the nerves in the body, and help release hormones.

Sources: milk, yogurt, cottage cheese, cheese, broccoli, leafy greens, beans, almonds, canned fish, and soy products.

Helpful Tips: Consume calcium-rich foods away from iron-rich foods to help increase absorption. Consume a source of calcium at each meal to help support bone health (4).

Healthy Fats:

Why it’s important: Good fats are essential for children as they grow up because they help with hormone production, help fuel the brain (70% of the brain is made up of fat!), and help with satiety. Good fats are also needed to absorb fat-soluble vitamins such as Vitamin D and A (5).

Sources: olive oil, avocados, fatty fish, nuts, seeds, nut butters

Helpful Tips: Avoid trans fats (also called partially hydrogenated or hydrogenated oils). Avoid fat-free products because when food manufactures remove the fat from a product they add in sugar for taste.

Foods to Avoid

Trans fats: Fats that should be avoided in the diet are trans fats (also known as partially hydrogenated or hydrogenated oils.) These fats are found in foods such as baked foods, fried foods, snack foods, and other processed foods.

Simple and refined carbohydrates: Foods such as white bread, white flour, most breakfast cereals, candies, and baked goods have been stripped from their nutrients and quickly raise blood sugar levels. A high consumption of simple and refined carbohydrates has been shown to increase the risk for heart disease and type 2 diabetes.

Caffeine: Many children are consuming caffeine on a daily basis in the form of energy drinks, sodas, and coffee drinks. Consuming caffeine can increase depression and anxiety in children, as well as increase irritability and problems concentrating in school (6).

Juice: Often thought of as a “health food,” contains a high amount of sugar without the fiber that a fruit provides. It’s best to consume whole fruit instead of drinking fruit juice, and limit juice intake to no more than 4 ounces per day.

Artificial sweeteners: Despite popular belief, research has found that artificial sweeteners can cause weight gain and increase the risk for conditions such as diabetes, heart disease, and high blood pressure. Some artificial sweeteners can be up to 300 times sweeter than regular sugar, and cause taste buds to prefer very sweet foods. This can become problematic if children are exposed to artificial sweeteners at a young age (7).

Serving Sizes

As children age their calorie needs and portion sizes will change. The following recommendations are serving and portion size recommendations. The amounts are dependent on age, activity level, growth spurts, and health status. It is best to talk with your child’s pediatrician or a registered dietitian to find the most appropriate calories and serving sizes for your child.

Pediatric nutrition needs by a Consultant Dietitian

Healthy Beverages

Water and milk should the primary beverage for children. It is recommended to drink half of a child’s body weight in ounces of water each day. For example, if a child weighs 60 pounds, they should drink 30 ounces of water each day. Children should drink 3 -8oz. glasses of unflavored milk each day. Sugary beverages such as juice, soda, sports drinks, and energy drinks should be limited to no more than 4 ounces per day due to their high sugar and caffeine content.

Healthy Snacks

Snacks are beneficial to incorporate between meals to increase nutrient consumption, obtain adequate calories for growth, and to help balance blood sugar levels throughout the day. Snacks should include a source of protein (such as nut butters, yogurt, or cheese) and fiber (such as from vegetables and fruit). It is important to set a schedule for snacks to avoid “grazing” all day long.

Examples of meal and snack schedule:

7:00 am – breakfast

9:30 am – morning snack

12:00 pm – lunch

2:30 pm – afternoon snack

5:00 pm – dinner

7:00 pm – bedtime snack

Tailor the schedule to meet your schedule and needs.

Examples of healthy snacks include:

  • Carrots with hummus

  • A cheese stick with apple slices

  • Plain Greek yogurt with fruit

  • Celery with natural peanut butter

  • Trail mix made with nuts, seeds, and dried fruit

Encouraging Healthy Eating Habits

Start the day with breakfast: Studies have found that children who eat breakfast in the morning can concentrate better in school, typically eat healthier throughout the day, have better moods and energy, consume more vitamins and minerals throughout the day, and perform better on tests.

No time in the morning? Grab Greek yogurt with fruit, or hard boiled eggs for a quick breakfast on the go.

Eat three meals per day with snacks between: Eating throughout the day helps keep blood sugars balanced, and helps fuel the brain and metabolism. Incorporate snacks between meals if the time between meals is more than three hours. Snacks are particularly beneficial for children in sports or going through growth spurts.

Avoid labeling food “good” or “bad:” When we put labels on foods it causes us to believe that we are good or bad when we consume them. Instead, focus on a “all foods fit” mentality, and focus on incorporating a variety of food groups and colors on the plate.

Eat at least three food groups at meals and two food groups at meals and snacks: To try to incorporate color and variety, aim to have at least three food groups at meals (e.g. chicken, vegetables, and rice) and two food groups at snacks (e.g. banana with peanut butter)

Involve children in food prep and cooking: Getting children involved in meal planning, grocery shopping, and cooking helps increase the likelihood of them consuming the foods. It also teaches them where food comes from, as well as skills in the kitchen that they will use throughout life.

Eat together as a family: Eating together as a family doesn’t just mean dinnertime. Eating together can happen at breakfast, lunch, or dinner. It’s important to find what works best for your schedule. The benefits of eating together as a family include increased nutrient consumption, less destructive behavior, better communication, and better grades in school. Aim to eat together as a family at least 2-3 times each week.

Have healthy foods available: Keeping foods such as vegetables and fruits available vs. processed foods such as chips or baked goods helps promote healthy eating habits. Have a snack bin in the refrigerator filled with cut up vegetables, fruit, cheese sticks, and yogurts.

Avoid the clean plate club: Forcing children to eat all of their food causes children to ignore their hunger cues and eat despite not feeling hungry. It is best to listen to a child when they say they are full and save the leftovers for another time.

Common Struggles Parents Face with Feeding Children

Picky Eating: At any given age between 13-22% of the children are reported to be picky eaters (8.). These behaviors can last more than two years. Dealing with a picky eater can be frustrating and tiring, but there are ways to help you manage it. Below are some tips to help with picky eating:

  • Exposure: Our taste buds are continuously changing, so if a child tried a food a month ago and didn’t like it, that doesn’t mean they won’t like it tomorrow. Continue exposing a child to a variety of foods because it can take 10-20 times of being exposed to a food item before they determine they like it.

  • Remove pressure: Pressuring a child to eat a certain food causes a stressful situation for both the parent and child. Avoid pressuring, bargaining, or giving them a treat for eating a particular food.

  • Follow the division of responsibility:

  • The parent is responsible for what, when, and where a child eats.

  • The child is responsible for how much and whether they will eat.

Allowing the child to take ownership in how much they would like to eat and what to eat can help improve eating habits and remove the stress and pressure at meal time (9).

Grazing: If a child is eating all day long it can lead to overeating, weight gain, irritability, and not feeling hungry at meal time. Below are some tips to help prevent grazing throughout the day:

  • Set a specific schedule for meal and snack times.

  • Tell a child when the kitchen will be closed so they can plan ahead.

  • Avoid processed foods which can be addictive and not filling.

  • Portion out foods instead of eating out of a bag or box.

Lack of time: Not enough time is a large reason why many families are not eating together as a family. Below are some tips to help make eating healthy easier when you are short on time.

  • Meal plan: Sit down on the weekend and plan out your meals and snacks for the week ahead. This saves a lot of time, stress, and money throughout the week.

  • Stock up on frozen produce: Who says you need to have fresh produce all of the time? Frozen produce such as broccoli or berries can be incorporated into a variety of meals and can be used for a longer period of time (which ultimately saves you time at the grocery store!)

  • Get the whole family involved: If the children are old enough, assign them a task to help with food prep such as dicing up vegetables, or putting ingredients into a smoothie.

  • Keep it simple: Meals do not need to consist of several courses. Keep it simple and stock up on items such as turkey burgers, chicken sausages, or eggs as well as frozen vegetables to heat up quick. Pair with some milk on the side and you have a balanced meal!

Lack of vegetables and fruit intake: Children don’t always understand the importance of eating vegetables or fruit, or even like the taste of them. Below are some tips on how to make vegetables and fruit more appealing and how to incorporate them easily into the diet:

  • Incorporate vegetables into a variety of foods: Soups, sauces, pastas, and smoothies are all great ways to incorporate vegetables.

  • Let your child help pick out the produce: Invite your child to pick out a new vegetable or fruit each week to try at the grocery store.

  • Add some flavor: Add a little bit of butter or spices such as garlic or parsley to vegetables to help improve the taste.

  • Serve them different ways: Serve the vegetables and fruit in different ways such as raw, roasted, or steamed to help change the texture and taste.

  • Add them to foods they already enjoy: Is your child a macaroni and cheese fan? Try adding broccoli or peas to it!

  • Keep them visible: Keep fruit on the counter, and vegetables in the front of the refrigerator so they are easily accessible.

Feeding and teaching a child what balanced eating looks like helps set the foundation for the rest of their lives. It’s not about perfection, but about balancing the plate with a variety of food groups and color. As a parent, you make a huge impact on how a child views and approaches foods so it’s important to set a good example for them.

No matter where you are in your health journey, remember that making small and simple changes can make a huge impact.

Cheers to helping our children be as healthy as they can be!

This article was written by our Pediatric Registered Dietitian Staff.

RD Nutrition Consultants LLC, is the industry leader in Registered Dietitian Consultant Services Nationwide. We specialize in providing contract Registered Dietitian services in a wide variety of healthcare and wellness organizations.

References

1. National Institutes of Health. 2016. Iron. Available at : https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/

2. National Institutes of Health. 2016. Zinc. Available at : https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/

3. Cleveland Clinic. 2018. Vitamin D and Vitamin D deficiency. Available at:

4. Teens Health. 2014. Calcium. Available at: http://kidshealth.org/en/teens/calcium.html

5. KidsHealth. 2017. Fats. Available at: http://kidshealth.org/en/parents/fat.html

6. Helpguide.org. (n.d.). Anxiety disorders and anxiety attacks. Available at: https://www.helpguide.org/articles/anxiety/anxiety-disorders-and-anxiety-attacks.htm

7. Azad, M.B. et al. sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Canadian Medical Association Journal, 2017; 189 (28): E929 DOI: 10.1503/cmaj.161390

8. Mascola, A.J., Bryson, S.W., Agras, S.W. Picky eating during childhood: A longitudinal study to age 11-years. Eat Behavior, 2010. 11(4): 253–257.

9. Ellyn Satter. 2016. Ellyn satter’s division of responsibility in feeding. Available at: https://www.ellynsatterinstitute.org/wp-content/uploads/2016/11/handout-dor-tasks-cap-2016.pdf

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