Nutrition for 6-12 year olds

Ruth CharlesConsultant Paediatric Dietitian

Ballinderry Clinic, St. Francis Hospital, Mullingar, Co. Westmeath.www.nutrikids.ie

Key growth periods in childhood

• Birth-age 1• Puberty

Growth in early years

Puberty growth spurt

Growth factors

• Genetics: parental height• Race• Genetic disordersSyndromes: Down’s, Turner’s• Congenital abnormalities: heart defects• Trauma (brain/bone injury, emotional)• Parasitic infection• Social environment & hygiene• Nutrition & food

Energy requirements for children

Adapted from Recommended Dietary Allowances for Ireland 1999, Food Safety Authority of Ireland

Nutrient requirements for Irish children

www.fsai.ie 1999 www.dohc.ie 2004http://www.dohc.ie/publications/pdf/primary_schools.pdf?direct=1 2003

Meal planning: Special considerations• Food allergy or intolerance: peanut free (egg, milk)• Vegetarian• Cultural food customs• Modified consistency (puree, mash, liquid)• Iron• Bone health• Dental health• Obesity• Athletic/active children• School Healthy Eating Policy

Food Allergy & Diabetes.

• Diabetes:– Frequency and timing of

eating.– Low GI foods– Exercise and food

• Food Allergy:– Reaction type/severity– What food involved

Bone health: Calcium (Phosphorus)

• Dairy: 3 servings per day for children. 5 servings a day for teenagers and pregnant/breastfeeding women.

• Serving= glass of milk (1/3 pint or 189 ml), 1 pot of yogurt or a matchbox-sized (1oz) piece of cheese.

• There is relatively no difference in the calcium content between full fat, low-fat and skimmed milk.

• Low fat milk is suitable for children over 2 years ( provided they are eating well) and

• Skimmed milk should not be introduced before the age of 5 years.

Ruth Charles, Consultant Paediatric Dietitian.www.nutrikids.ie

Bone health Vitamin DActive form Vitamin D3 is required (cholecalciferol) Non Food sources:

UV radiation . Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation (>SPF 8)5–30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back

Dietary sources: Most margarinesSome fortified brands of soya milks, yogurts and desserts – check the labelA few fortified breakfast cereals – check the labelDried skimmed milkFortified yoghurtsEggsOily fish: mackerel, herring, tuna, salmon

Careful consideration needed:Exposure to sun, dark skin, elderly, infants. NEW RECOMMENDATION Vitamin D3 requirement: Children 0-1 year: 5µg/200 i.u.

October 20, 2011

Cultural food customs

Dental Health

Obesity• 1 in 5 Irish Children are overweight/obese• Personal and parental accountability is paramount. • More children will die of obesity associated medical

problems without national strategies.– Cancer– Coronary artery disease– Insulin resistance & Diabetes– Joint & bone health

• Prevention better than cure– Healthy Eating & Food Pyramid– Physical Activity

At least one hour of moderate intensity every day

Role of physical activity in childhood

• Bone strength & density: weight bearing exercise.• Agility, balance, coordination and speed.• Key motor skills• “proficiency barrier” developing the simple activities of

early childhood to the more complex activities of later years.

• Self esteem & confidence• Cardiovascular health

Fuel for sport

Calories/energy sourcesFluidsTime to eatNeed for snacks

Food refusal

• Common• Learned behaviour• Repeated if the desired result is obtained• 10-15 new food exposures required • before acceptance• Disguise the food/taste• Eating at the same time. Eating new foods

together. Sitting together at the table.

School lunch

Should be considered as a mealEnough allocated time?Important part of the school day.With increasing age, more time spent in

school.

Translating recommendations to practice

Ruth Charles, Consultant Paediatric Dietitian.www.nutrikids.ie

Energy

Carbohydrates: Cereals, grains, bread, Potatoes. Wholegrain varietiesSandwiches, Popcorn, pretzels, crackers, oatcakes.(sugar coated cereals, white pan bread, pasta, convenience

frozen/ready to eat food, deep fried food)Sugar: natural (fruit, usually fructose) vs. added (usually

sucrose)Sugar free usually means sucrose free (fructose/glucose)Fat: PUFA/MUFA better for health than saturated/trans fats

October 20, 2011

Getting “wholegrain” into children’s diets

How to read a food label

Fruit and veg.

• More than 4 portions a day• Different coloured fruit and veg: broccolli,

peppers, carrot, tomato, blueberries• Homemade soup/gravy• Raw carrot, celery/cucumber sticks• Mixed salad• Smoothies using pulped fruit• (Pure fruit juices)

Reduce intake of top shelf foods:twice per weeks is reasonable

Healthy Snacks

Suitable drinks

Menu planning

Checklists•Food allergy or intolerance•Vegetarian•Cultural food customs•Modified consistency (puree, mash, liquid)•Iron•Bone health•Dental health•Obesity•Athletic/active children

Free resources

• www.healthpromotion.ie• www.irishheart.ie/media/pub/kids/on_the_go

_booklet_final.pdf• www.littlesteps.eu• www.fooddudes.ie• www.indi.ie

Thank you

School lunchHealthy lunch box – putting ideas into practice: Wholemeal bread with cheese slice and tomato + 1 banana + sugar free squashPitta bread with cooked ham, low-fat mayonnaise lettuce and cucumber + orange segments + milk to drinkBurger bun with chicken, relish, lettuce and grated carrot + dried fruit + yoghurt + water to drinkToasted wholemeal bread with cooked beef, tomato and cucumber + small apple + milk to drinkCooked pasta with tuna, lettuce, tomato and carrot + 2 mandarins + yoghurt + unsweetened pure fruit juiceSalad box with cooked rice, lettuce, tomato, cheese cubes, celery sticks, carrot sticks + dried fruit + water to

drink White roll with mashed hard boiled egg, lettuce and cucumber + handful of grapes + sugar free squash/milk to

drink.Wholemeal bap with lean grilled bacon, tomato and sweetcorn + peach + milk to drinkCrackers with cheese slices, sliced peppers, grated carrot +apple and orange segments + water to drinkCooked rice with cooked peas, carrot and chicken pieces + dried fruit + unsweetened fruit juiceHummus sandwich + Banana + unsweetened fruit juiceDrinks It is important that children take in enough fluids during the day. Almost 2/3 of the body is made of water. If

children do not drink enough water, they may become dehydrated, thirsty, tired and weak.Drinks should always be included for lunch and break-time. Water and milk are the best choices and milk is also

a valuable source of calcium, which is important for healthy bones and teeth. Unsweetened fruit juice/ diluted sugar free squashes are also suitable drinks if taken with meals. Children

should be encouraged to drink fluids with meals and not to fill up on drinks before meals