Childhood nutrition concerns the dietary needs of healthy children ages 2 through 11. Children younger than 2 and older than 11 have different nutritional requirements and concerns. In addition, parents of children with special health needs or dietary restrictions require individualized diet advice. They should consult a pediatrician or a registered dietitian about their child's diet.
Proper nutrition for a healthy child should provide sufficient amounts of essential nutrients, fiber, and energy (calories) to maintain normal growth, maximize cognitive development, and promote health. The diet should be balanced so that foods rich in some nutrients do not displace foods that are rich in other nutrients, and so low-nutrient foods (“empty calories”) do not displace nutrient-dense foods. A child's diet should provide sufficient energy for proper physical and mental growth and development while preventing excess weight gain.
Childhood is a time where many food likes and dislikes are determined, largely based on the family's food choices, socioeconomic status, budget, cultural and/or religious experiences, time constraints, and various other factors. For children, the food environment in which they are raised has a significant effect on food choices later in life. Parents, guardians, and others need to pay special attention to nutrition and food choices to support a wide variety of tastes and preferences.
Healthy eating habits in childhood have been shown to prevent chronic undernutrition and physical and cognitive growth problems as well as nutritional concerns such as iron-deficiency anemia and dental caries (cavities). A healthy diet in childhood can help prevent obesity and weight-related diseases, such as type 2 diabetes, which is increasingly diagnosed in children in the United States.
In 1980, the U.S. Department of Agriculture (USDA) released the first edition of Dietary Guidelines for Americans. The most recent edition was released in 2015 and focuses on healthy eating patterns and food and nutrient characteristics that can help people of all ages to achieve and maintain good health and to reduce risk of chronic disease. The new guidelines acknowledge the role of physical activity and the importance of all groups in society working together to support healthy choices. The importance of families and schools working together to enable healthier food and lifestyle choices is acknowledged.
Some general guidelines from the 2015 directive include:
MyPlate remains a user-friendly visual for families to create healthy patterns, acting as a nutritional plate for each meal. The plate is divided into roughly 30% grains, 30% vegetables, 20% fruits, and 20% protein. A smaller circle separate from the plate represents dairy products.
Although MyPlate's general recommendations apply to almost all age groups, suggestions are made for specific groups, including infants, preschoolers, and children. These suggestions include information about specific food groups, as well as sample menus and tips for improving eating habits. Some general guidelines for kids ages 2–11 include:
The USDA guidelines are based on the most current research by nutrition scientists and have a very high level of acceptance by health professionals. For healthy children, there are no perceived precautions or risks associated with following these guidelines. Children younger than 2 or older than 11 should follow the recommendations for their particular age groups. Children of any age who have special health concerns or dietary restrictions may not be able to adhere to the USDA guidelines and should follow the advice of their pediatrician or a registered dietitian (RD).
In addition to addressing children's energy needs, the guidelines take into consideration the need for specific nutrients to avoid the development of undernutrition or malnutrition. For example, adequate intake of calcium and vitamin D in children helps build strong bones and is a preventative measure against osteopenia and rickets (and later in life, osteoporosis). Adequate calcium and vitamin D intake is crucial during adolescence and early adulthood to reach peak bone mass. Failure of children to meet the requirements, in combination with a sedentary lifestyle, makes achievement of maximal skeletal growth and bone mineralization challenging. Recommendations include several servings a day of low-fat or nonfat milk and dairy products such as yogurt in a child's diet.
Iron deficiency has negative effects on children's cognitive development and can affect their capacity to do well in school. Adequate intake of foods high in iron, such as meats and fortified breakfast cereals, will help ensure that iron requirements are met.
Although nutrient intake is important, overconsumption of nutrients can cause other problems. High saturated-fat intake is associated with increased low-density lipoprotein (LDL or “bad”) cholesterol in childhood. This ultimately can increase the risk of cardiovascular disease and type 2 diabetes. A diet that includes lean meats (for example, red meat and poultry) and low-fat or nonfat dairy products and limits foods high in saturated fat can help implement healthy habits and decrease a child's risk of developing type 2 diabetes or cardiovascular disease later in life.
Before children are two, parents should focus on making sure their infant or toddler is consuming enough calories and nutrients to support growth and development. As the child ages, a shift occurs, and parents become more focused on the types of food their child is eating. A transition is made from the higher-fat foods needed in infancy to lower or nonfat versions. During this time, children are highly influenced by flavor and will be guided to eat foods for taste instead of nutrition content, so parents need to be aware of what their children are eating and should limit foods high in fat and added sugar. Parents are also responsible for making sure that the foods offered are safe and appropriate for their children and their developmental skills.
For parents, childhood can be a time of food quarrels as their child is becoming more independent with eating habits. When children are young, parents are responsible for what, when, and where the child eats. It is important that parents be attentive to the nutritional needs of their children and ensure that they are supplying appropriate foods in amounts that meet nutritional requirements. For younger children, having a set schedule of meal and snack times may help achieve nutritional balance. Parents should also be aware that a child's appetite will change (often as a result of changing rates of growth) and, as such, children may be unpredictable in the amounts of food that they want to consume. It is important for parents to find a balance between encouraging a child to eat and allowing the child to determine when and how much to eat rather than forcing them to eat.
As habits are being formed during these years, it is important for meals and snacks to be a social and a pleasant time. Screen time and other distractions should be avoided. Eating the same healthy foods as the child and encouraging him or her to try new foods will help provide a model of healthy eating. Parents should also not use food as a reward for good behavior, as a bribe, or for entertainment.
Children with food allergies or intolerances or other medical concerns may display poor growth, poor eating skills, inadequate food intake, developmental delays, elimination problems, or metabolic disorders. Parents who are concerned about their child's health should visit a pediatrician and express their concerns. If a problem is found to be related to the child's diet, a referral to a specialist is important for early intervention so that it will not affect longterm growth and health.
For healthy growth and development, children should be encouraged to be as physically active as possible. The recommendation for children ages 6 to 17 years is 60 minutes or more of physical activity per day and to incorporate a combination of aerobic exercise with smaller amounts of bone and muscle strengthening exercises.
See also Body image ; Calcium ; Childhood_obesity ; Children's diets ; Food allergies ; Food insecurity ; Infant nutrition ; Malnutrition ; MyPlate ; Obesity .
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Tish Davidson, AM
Revised by Anne P. Nugent, PhD RNutr