Childhood nutrition involves making sure that children eat healthy foods to help them grow and develop normally, as well as to prevent obesity and future disease. The traditional or mainstream approach to good childhood nutrition is to follow suggestions based on dietary guidelines that are appropriate for a child’s age and development level and that have been developed and recommended by government, research, and medical professionals. The guidelines include selections from different food groups to provide the vitamins and minerals young bodies need for natural growth and activity. The U.S. Department of Agriculture’s (USDA’s) Food Guide Pyramid recommends how many servings a day a child should eat of each food group, such as milk, vegetables, fruits, fats, and meats, and asserts that by sticking closely to the guidelines, parents can ensure their children get a well-balanced diet that supplies the vitamins, minerals and calories they need to support growing bodies and active lifestyles. However, in this age of what has been called ‘‘advanced medicine,’’ there are those who seek to understand why so many among us, especially children, suffer from so much serious illness.
The Food Guide Pyramid and other healthy eating recommendations generally apply to children age two and older. When used as a starting point for planning family meals and snacks, applying these sensible recommendations to children’s daily diets can encourage good eating habits at an early age. This will help children develop mentally and physically according to growth charts and other measurements set by pediatricians (physicians who specialize in caring for children) and will help prevent future problems with overeating or with eating disorders. Many nutritional experts agree that if children eat a balanced diet that includes all of the recommended food groups, they will not need to take vitamin/mineral supplements.
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Children two to five years of age
The AMA and USDA recommend food guidelines for young children similar to those for older children and adults, but with smaller portions. When looking at a range of portion sizes, parents and those who care for young children should choose the smaller portion sizes for children age two or three, and go with a slightly larger portion for children who are age four or five. Daily recommendations include:
– four to five servings of breads, cereals, rice, pasta
– two or more servings of vegetables
– two or more servings of fruit
– three to four servings of dairy products
– two or three servings of meat, fish, poultry, legumes (beans, lentils, peas) After age two, a child needs less fat than an infant—about 30% of daily calories. After age three, fiber becomes more important in a child’s diet and can impact future heart health. Calcium requirements steadily increase as children get older, from 500 mg a day at age three to 800 mg a day at age four to eight. There is more calcium in the body than any other mineral. Calcium works together with phosphorus (two parts calcium to one part phosphorus) for healthy bones and teeth and works together with magnesium (two parts calcium to slightly over one part magnesium) to prevent cardiovascular (blood vessels of the heart) and other degenerative diseases. In order for calcium to be absorbed by the body, it must also have sufficient amounts of vitamins C, D and A. In addition to food sources, an hour of sunshine each day can also provide a child with his/her daily vitamin D requirement.
Children six to 12 years of age
By the time children reach age five or six, they begin to tell parents what foods they like. Parents and those who care for the children can help select foods from each recommended group that a child will enjoy. Calorie requirements and portion sizes increase as children get older: between ages six and 10, boys and girls need between 1,600 and 2,400 calories each day.
Because of puberty and adolescent growth, between ages 10 and 12, girls need about 200 more calories a day. Boys will begin needing about 500 more calories a day after age 12. The following servings per day are recommended for children ages six to 12:
– six to 11 servings of breads, cereals, rice, pasta
– three to five servings of vegetables
– two to four servings of fruit
– three or four servings of dairy products
– two or three servings of meat, fish, poultry, legumes
By age six, children still need only about 30% of calories from fat. Nutritionists say that by adding five to the child’s age, parents can estimate the number of fiber grams a child needs each day. Calcium requirements continue to rise, from 800 mg a day at ages four to eight to 1,300 mg each day for children beginning at age nine.
Very useful tips on nutrition for children:
Getting children to eat the right foods is easy if they begin good eating habits at a young age and if they are offered a variety of healthy foods. Many books, magazines, and web sites offer tips on making healthy foods interesting. Some suggestions for each food group follow.
– breads, cereals, and pastas including whole grain breads, unsweetened cereals, unrefined rice, whole grain crackers, cornbread, rice cakes
– vegetable servings from cooked or raw vegetables such as asparagus, beets, broccoli, carrots, corn, green and red peppers, green beans, kale, peas, pumpkin, squash, sweet potato, tomato, zucchini, or vegetable juice
– good fruit choices such as apples, applesauce, bananas, cantaloupe, apricots, peaches, unsweetened fruit cocktail, plums, grapefruit, kiwi, nectarines, strawberries, watermelon, and fresh fruit juices
– milk, low-fat yogurts and cheeses are good dairy sources, as are low-fat cottage cheese, custard, ice milk, and occasional ice cream servings
– meat, fish, poultry, and legume choices include lean meats, dried beans, peanut butter, shellfish, dried peas, lentils, tofu, and reduced-fat cold cuts
To reduce fat in a child’s diet, parents can switch to low-fat or non-fat milk; remove skin from poultry or trim fat from red meat; reduce use of margarine and butter; use low-fat cooking methods such as baking, broiling, and steaming; and serve foods rich in fiber. Fresh salads can improve fiber in diet, as can adding oat or wheat bran to baked foods. Good, easy-to-assimilate sources of calcium for children, besides milk and cheeses, are tofu made with calcium sulfate; soup made with fish, fowl or beef bones and one tablespoon of wine vinegar to draw out the calcium into the broth; canned salmon and sardines with bones; sesame seeds and tahini (ground sesame seed butter); beans and nuts; calcium-fortified fresh orange juice; greens, especially broccoli, collards, kale, mustard, turnip tops, parsley, watercress and dandelion; and cooked sea vegetables if children like them.
Only the fat-soluble (capable of being dissolved in fat or oil) vitamins A, D,Kand E have side effects that are potentially, though rarely, toxic (poisonous). In their book The Real Vitamin & Mineral Book, Sheri Lieberman and Nancy Bruning state, ‘‘The facts are that only a few vitamins and minerals have any known toxicities, all of which are reversible, with the exception of vitamin D. Anything can be harmful if you take enough of it—even pure water. But vitamins and minerals are among the safest substances on earth.
The amounts needed to become toxic are enormous.’’ They add that being on medication or having a medical condition can influence vitamin/mineral requirements and indicate that when one’s physician is not well-versed in nutrition, it is ideal to have him work with a qualified nutritionist.
With regard to vitamin D, they indicate, ‘‘According to several studies, up to 1,000 IU per day of vitamin D appears to be safe. Both the beneficial and adverse effects of exceeding this amount are controversial. Overdosing of vitamin D is irreversible and may be fatal. Symptoms of too much vitamin D are nausea, loss of appetite, headache, diarrhea, fatigue, restlessness, and calcification of the soft tissues (insoluble lime salts in tissue) of the lungs and the kidneys, as well as the bones.’’ Vitamin D (400 IU) is usually sold with vitamin A (5,000 IU) in a tiny tablet or capsule.
Lieberman and Bruning say that active vitamin A from fish liver oil or synthetic palmitate is stored in the liver; that 15,000 IU would cause problems in infants; but that 100,000 IU of active vitamin A would have to be taken daily for months before any signs of toxicity (state of being poisonous) appear. Vitamin A in the form of beta-carotene can be taken without any risk of toxicity. At doses of 800–1,200 IU per day, Lieberman/ Bruning found no well-documented toxicity of vitamin E. At doses of over 1,200 IU per day, adverse effects such as flatulence, diarrhea, nausea, headache, heart palpitations, and fainting have been reported, but were completely reversible when dosage was reduced. Vitamin K is easily obtained by the body from a healthy diet and deficiencies are rare, especially in children. It is given prophylactically to newborn infants to prevent hemorrhage and before surgery to people with blood-clotting problems. Lieberman/Bruning describe the major effect of too much vitamin Kas an anemia where red blood cells die more quickly than usual and cannot be replaced by the body.