Balancing your child’s diet – are you getting it right?

Trying to balance your child’s diet with the right proportion and variety of foods can sometimes feel more challenging than mastering Pythagoras’s theorem. New research from the Infant & Toddler Forum supports this, revealing that while the majority of the nation’s parents are confident naming the main food groups that should form a balanced diet, they frequently struggle to combine them in appropriate quantities.

A healthy balance

A healthy balanced diet for children aged one to five years is based on the four food groups listed below, which together provide a range of essential nutrients that children need to grow and develop:

  • Starchy foods (such as bread, rice and pasta)
  • Meat, fish, eggs, beans and other non-dairy sources of protein
  • Milk and dairy foods
  • Fruit and vegetables

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Whilst parents are familiar with these food groups, the study reveals that over a third of parents admit they are worried that their child doesn’t receive the right balance of these foods and more than a quarter feel their child doesn’t consume sufficient variety. The survey also revealed some worrying parental misconceptions surrounding recommended quantities of each food group.

Starchy Foods

  • Nearly 65% of parents believe they should only offer their toddler starchy food once or twice a day
  • Only a quarter of parents are aware that they need to be offered three-to-five times a day.

Starchy foods provide energy, carbohydrate, fibre and B vitamins. With this in mind, a portion of starchy food should be offered as part of every meal plus at least one snack each day.

Starchy_CarbohydratesThere is also a common misconception amongst parents that wholegrain carbohydrates (such as brown rice and brown pasta) are a healthier choice for children than refined alternatives (white rice and white pasta). In fact, while young children should be

encouraged to eat some wholegrain starchy foods, they shouldn’t be restricted to these alone as they are very high in fibre. These means toddlers can fill up before they have taken in the energy they need. Parents should therefore provide a variety of wholegrain and white starchy foods each week.

Protein

  • Only half of parents are aware that they should offer protein in the form of meat, fish, eggs, nuts and pulses two or three times a day

proteinsFood from this group provide protein, iron and zinc and should be included as part of lunch and tea each day. Protein can also be provided as part of snacks once or twice each week.

Despite protein being the most important food source of iron, which one in eight toddlers don’t get enough iron in their diet. Poor iron levels are linked to slower intellectual development and poor behaviour in the longer term.

However, parents should be mindful of the protein sources they provide. Meat and fish products, and products made from meat alternatives (such as Quorn), can be high in salt and saturated fat. Parents should limit bought and homemade meat and fish products to no more than once a week. Making homemade versions of these products can ensure that the fat and salt content is lower.

Sugar

  • 22% believe there should be a complete ban on giving their child cakes, biscuits and sweet puddings

Most parents confess to being overly cautious of sugary foods, no doubt due to extensive media coverage relating to the obesity epidemic. However, desserts and cakes can provide an important source of energy (calories), plus essential nutrients such as calcium and iron. Desserts, puddings and cakes made with cereals (such as rice or oats), milk and fruit should therefore be included as part of a healthy, balanced diet for young children and children should be encouraged to learn how to enjoy healthy foods and sweet treats side-by-side.

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For this reason, the Children’s Food Trust recommend that a dessert should be provided as part of lunch and tea each day. They suggest a variety of options (such as crumbles or baked apples, semolina, rice pudding or custard, yoghurt or fromage frais, carrot cake or fruit flapjack and fruit salads) rather than relying on fresh fruit alone. The exception to this is confectionery and sweet drinks, (including fruit juices) which should be limited to once a week, to help protect children’s teeth.

Meal planning: a practical guide

One of the basic principles of healthy eating is variety – simply put, eating a wider range of different foods provides a better balance of nutrients. Planning meals and snacks to include a variety of food and drinks from the four food groups each day will therefore provide children with a good balance of nutrients they need to ensure they receive the right amount of energy and nutrients. It can also help encourage them to develop good dietary habits to take with them into later childhood and beyond.

The trick is to mix it up at every meal, being mindful to include a little bit of every food group and not rely too heavily on any one type of food. Since children have smaller stomachs and might not get all their energy from the three core meals, they also need nutritional snacks in between the meals to boost their energy intake.

To help guide parents and care providers, the Children’s Food Trust provide the following summary of the 4 food groups, the nutrients they provide and recommended servings:

summary table

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Food for concentration & cognitive function

The impact of poor nutrition on obesity and associated chronic diseases is well established. However, evidence suggests that the quality of a child’s diet not only has a considerable impact on their weight and long term health – but also their ability cope with the behavioural and academic demands of school or nursery. A well-fed brain is more likely to lead to good behaviour and improved learning outcomes.

Food for the brain

During the first two years of life, a child’s brain develops rapidly. Nutrients play an important role in this development process, acting as energy sources, structural components and precursors to neurotransmitters (the brain’s chemical messengers). Children who don’t receive adequate nourishment during this critical period are therefore at risk of a range of cognitive problems including slower language, lower IQ and poorer academic performance in later childhood.

So which nutrients are particularly important? And where can they be found?

  • Omega 3 fats

4364560% of brain weight is fat, so it’s no surprise that deficiencies in certain fats can have a huge impact on intelligence and behaviour. Most of the connections in the brain are laid down by the age of two, so around 50% of a child’s total calories should come from fat during this period to ensure optimum brain development.

Almost half the fat in the brain is docosahexaenoic acid (DHA), a type of omega 3. DHA helps support the transportation of signals to and from the brain and forms the basis of memory. Studies suggest that children who eat foods rich in DHA therefore display improved recollection skills.

Found in: DHA is not produced by the body in significant amounts, which means it must be obtained through diet or supplementation. The most effective omega 3 fats occur naturally in oily fish such as salmon trout, mackerel, herring and sardines. For those who don’t like fish, flaxseeds and walnuts are also good sources.

  • Zinc

Zinc is important for the hippocampus – a region of the brain linked with learning and memory. Low zinc levels have been linked with fussy eaters and the development of ADHD. In turn, improving zinc levels in children with ADHD has been shown to reduce symptoms of hyperactivity, impulsivity and impaired socialisation.

Found in: Meats such as lean beef and poultry, dairy products (including yogurt and cheese), nuts, seeds, beans and pulses.

  • Iron

Iron deficiency in 1-2-year-olds has been linked to poor concentration and long-term learning and behaviour problems. Research suggests that around 85% of children with ADHD have low iron levels (compared with just 18% of children without the condition).

Found in: Lean meat, fish and protein-rich meat alternatives (such as eggs, beans, pulses and tofu). It’s also important to provide vitamin C (found in fruits and vegetables) to help aid iron absorption.

  • Magnesiumspinach-dd-02

Magnesium is used to produce the neurotransmitters involved in attention and concentration, and has a calming effect on the brain. Deficiencies amongst children are common.

Found in: Dark leafy greens, nuts, seeds, fish, beans, whole grains, avocado, yogurt, bananas and dried fruit.

  • Choline

Choline is a nutrient involved in the production of the neurotransmitter acetylcholine. Acetylcholine is important in the creation of memory stem cells, and therefore helps to boost memory.

Found in: Beans, brussels sprouts, broccoli, cauliflower, yogurt, tofu, buckwheat and lean beef. Egg yolks are also a great source of choline, but should not be given to children until 8-9 months.

Additional strategies

As well as making an effort to incorporate key nutrients, there are some additional nutritional and lifestyle strategies that can help improve behaviour and support the growing brain:

  • Blood sugar balance

It is important to keep children’s blood sugar levels stable. Too much refined sugar and children can become hyperactive and find it hard to concentrate. In addition, the brains of young children need a regular supply of energy so that they can think effectively. Lengthy gaps between meals can cause blood sugar levels to dip, and may leave children feeling tired, irritable and easily distracted.

Where possible, opt for slow release 1carbohydrates (such as wholegrain bread, brown rice, whole wheat pasta and oats) paired with a source of protein (such as meat, fish, eggs, nuts, seeds, beans and pulses) to help slow down the absorption of sugars from food. Eating little and often (i.e. main meals interspersed with healthy snacks) also helps keep children’s energy and concentration steady.

  • Reduction in junk food

Research suggests that high junk food diets in children can lead to increased hyperactivity levels. In a society dominated by convenience foods, encouraging a shift towards natural, unprocessed whole foods may seem challenging – but will often lead to improved learning outcomes.

A number of synthetic food additives designed to increase shelf life and enhance colour have been linked to hyperactivity in children and should be avoided where possible. These include tartrazine (E102), quinoline yellow (E104), sunset yellow (E110), carmosine (E122), ponceau 4R (E124), allura red (E129) and sodium benzoate (E211).

  • Water

Dehydration adversely affects concentration and mental performance, so it’s important to ensure that children drink plenty throughout the day and that fresh drinking water is always available.

  • ExerciseGame-Card-Glass-Vintage-GraphicsFairy001

As well as a healthy diet, exercise helps to keep brains sharp. Research suggests that regular physical activity improves cognitive function and helps children to process information more effectively.

Providing a nutrient-dense diet doesn’t need to be complicated or expensive. Children need nearly 40 different nutrients and the more varied their diet, the more likely it is that they will get enough of everything they need. Providing small yet frequent meals that includes a wide variety of fresh ingredients (including wholegrains, a good mix of lean meat, fish and vegetarian proteins, plenty of colourful fruits and vegetables and lots of water) is the most effective ways of ensuring that children’s brains are well nourished.

Nutrition for school sports

Nutrition helps provides vital fuel for physical activity, and it’s crucial that active children and adolescents consume well-balanced meals and snacks to help support school sports.

6754603d4ec0cfbeba712814e4d5d373Eating well for physical activity and sport can have many benefits including:

  • Increased energy and improved sporting performance
  • Reduced risk of injury
  • Better recovery after exercise

School-age children (aged 6 to 16) generally need between 1,600 and 3,200 calories a day. Those who consume healthy, well-balanced meals and snacks will get all the nutrients needed to perform well in sports, with no additional calories required. However, the timing of eating and exercising can impact on how children feel and perform during their chosen activity, as well as the balance of macro-nutrients consumed at each stage.

Before exercise

  • If children don’t eat anything at all before taking part in sports, they may lack energy and feel light headed. However, too much food can slow them down and make them feel unwell. It is therefore important to time food consumption right.
  • If children are consuming a full meal before exercise, this should be eaten around 2-3 hours prior to allow for adequate digestion. A small snack can be consumed around 30-60 minutes before exercise to help to top up energy levels.
  • It takes the body approximately four to six hours 20120531-154158-800x533to digest fat, around three hours to digest protein and about two hours to digest carbohydrates. It is therefore important that children focus on consuming mainly easily digestible carbohydrates directly before sports, so the body can focus on fuelling exercising muscles rather than digesting a heavy meal.
  • Making sure children are well hydrated before they start an exercise session is important, so encourage them to drink regularly throughout the day and with their pre-exercise meal. A sports drink is OK once in a while, but these drinks contain a lot of sugar and calories so water or diluted fruit juice is a better choice.

Food suggestions

  • An ideal pre-workout snack is a banana and a couple of oatcakes; this will provide a boost of energy without weighing children down. Bananas are also packed with potassium, which aids in maintaining proper nerve and muscle function
  • If eating several hours beforehand, a meal based around wholemeal pasta or brown rice with plenty of colourful vegetables is ideal. This is a great way to increase stored
    energy in the muscles and give children the extra oomph they need later in the day

During exercise

  • Game-Card-Glass-Vintage-GraphicsFairy001It is generally not necessary for children to consume food during exercise, unless they are participating in endurance or high intensity sports lasting over 60 minutes (such as long distance running or competitive swimming events). This is when carbohydrate stores may substantially decrease.
  • It is, however, important for children to consume plenty of fluids during exercise, especially if they are exercising in high temperatures. It is important not to wait until children are thirsty to allow them to drink, as this is a sign that they are already dehydrated.

After exercise

  • Children will often feel very hungry after exercise, and food and fluid intake is crucial for optimum recovery after sporting activities. After exercise carbohydrate stores will be lower, so it is important that they are replenished with a carbohydrate-rich meal –
    especially if the child is doing more exercise later on that day or the following day
  • The post-exercise meal should also include high
    quality, lean protein. Consuming this as soon as blafre20-294x300possible after exercise will be most beneficial for recovery, helping to repair exercise-induced damage to muscle fibres and help reduce soreness.
  • If children are unable to have a full meal after exercise, try to ensure they have a small snack that contains both carbohydrate and protein within the first 30-60 minutes to help begin the recovery process
  • To replace the fluid lost from sweating, it is vital to restore hydration levels as part of recovery, so remember to encourage children to keep drinking plenty of fluids after exercising

Food suggestions

  • A chicken sandwich or salad with sliced avocado or a piece of fruit and a handful of nuts are ideal post-sport snacks. Alternatively, a vegetable omelette or a baked potato with tuna or beans contains the perfect mix of carbohydrates and protein to help children get the most from their sporting activities.

© Sarah West Nutrition

Supplements for children – are they necessary?

Good nutrition in the early years is vital. It is during this time that children create lifelong food preferences and set the foundations for long-term health – making pre-school children far more nutritionally vulnerable at this point than in any other phase of their life. Despite this, many children still aren’t getting the balanced diets they need.

Ideally, children should get their vitamins from a balanced, healthy diet that includes:

  • 4364Starchy foods like wholemeal bread, pasta, oats and brown rice
  • Milk and dairy products like cheese and yogurt
  • Plenty of fresh fruits and vegetables
  • Protein such as lean meat, fish, eggs, beans and pulses

However, many children aren’t consuming balanced, nutrient-dense meals. Picky eaters and children with food allergies or intolerances often don’t consume sufficient calories or are reliant on highly processed convenience foods, which are deficient in the vitamins they need to grow and develop.

The 2016 National Diet & Nutrition Survey, an annual survey designed to assess the food consumption and nutritional status of the UK, supported this. It revealed that:

  • Children are consuming almost three times more sugar than the daily maximum recommendation (amounting to 13% of their daily calorie intake)
  • Intake of added sugars exceeds the recommendation – most notably for children aged 4 to 10
  • Consumption of sugar-sweetened soft drinks (which can leach vitamins and minerals from the body) is still too high
  • Average salt intake in children aged 4 to 18 years exceeds recommendations
  • Just 8% of children are meeting the 5 a day recommendation for fruit and vegetable consumption
  • Average consumption of oily fish (one of the best dietary source of Vitamin D) is well below the recommended one portion per week

The role of supplements

The Department of Health therefore recommends that all children aged six months to five years are given vitamin supplements containing vitamins A, C and D every day. It is also recommended that babies who are breastfed are given a daily vitamin D supplement from birth. The only children exempt from this recommendation are babies who consume more than 500ml (about a pint) of fortified infant formula a day.

Addressing vitamin deficiencies is a key part of the UK Government’s Healthy Start initiative, supporting families with children under the age of 4 years. Women supported by vitamins_image-e1396976178979Healthy Start are entitled to free vitamin tablets during pregnancy and until their child is one year old. Children aged from six months to their fourth birthday are also entitled to free vitamin drops.

Healthy Start children’s vitamin drops contain:

  • Vitamin A: For growth, vision and healthy skin. Also found in colourful fruits and vegetables
  • Vitamin C: To help maintain healthy tissue in the body. In a balanced diet most of the vitamin C required can be sourced from fruit and vegetables, but a supplement will help ensure young children get enough – particularly as vitamin C isn’t stored by the body
  • Vitamin D: For strong bones and teeth. Babies and young children under the age of 5 are considered an ‘at risk’ group for vitamin D deficiency – with statistics suggesting that Vitamin D intake for children aged 1.5 to 3 is currently just 20% of the recommended nutrient intake (RNI)

Despite the recognised need for such nutrients, the vitamin scheme is currently underutilised by many parents. Over 500,000 women and children currently benefit from Healthy Start food vouchers, but very few claim their Healthy Start vitamins – meaning the scheme is not fulfilling its potential to address widespread vitamin deficiencies and potentially improve the health of future generations.

How to get Healthy Start vitamins

Click here to find phone numbers and addresses for local distribution points around England. You can also ask your midwife or health visitor. Beneficiaries are entitled to one bottle of vitamin drops every eight weeks.packshot_strawberryliquid

Bassetts also do a range of liquid and chewy multivitamins that use sweeteners and natural flavourings to make them more palatable for young children. The range includes additional nutrients such as omega 3 fatty acids, making them ideal for fussy eaters. Try the strawberry flavour liquid multivitamins for children aged 6-36 months or the soft and chewy variety for those aged 3-6.

Disclaimer: Having too much of certain vitamins can be harmful. Always keep to the recommended dose stated on the label, and be careful not to give your child more than one supplement at the same time.

© Sarah West Nutrition