 Key points
• A varied diet containing adequate energy and nutrients is essential for normal growth and development, which at times can be very rapid.
• National survey data suggest that there has been a reduction in the percentage of energy derived from fat (with average intakes of total fat in line with recommendations for adults), with a corresponding increase in the proportion of energy derived from protein and carbohydrate.
• Average intake of saturated fatty acids still exceeds government targets for adults, while some children (e.g. older girls) have low micronutrient intakes or status.
• A large proportion of children are inactive, spending less than one hour a day participating in activities of moderate intensity.
A varied diet containing adequate energy and nutrients is essential for normal growth and development, which at times can be very rapid.
ENERGY AND NUTRIENT REQUIREMENTS
The energy requirements of children increase rapidly because they are growing quickly and becoming more active. They have a high energy requirement for their size. To achieve this energy intake, foods which are high in energy (and also rich in nutrients) and eaten as part of small and frequent meals may be necessary for younger children (e.g. 4-6 year olds), who do not have large enough stomachs to cope with big meals.
Despite this need for a high energy intake, however, the 2002 Health Survey for England found that about 1 in 5 boys (21.8%) and over 1 in 4 girls (27.5%) were either overweight or obese. These children should not be expected to lose large amounts of weight. They should be encouraged to remain at a constant weight or increase weight slowly while their height increases, so that they grow to be an acceptable weight for their height. Developing a healthy family lifestyle is important in the weight management of children.
A good supply of protein, calcium, iron and vitamins A and D is also necessary during this time. Calcium is needed for healthy tooth development and, together with vitamin D, helps make bones stronger. Childhood is an important time for tooth and bone development.
Children should be taught to think about dental hygiene and ways of preventing dental caries. They should be encouraged to reduce the number of times a day that they have foods and drinks containing sugar and, if possible, to have them only at meal times. Brushing teeth regularly with a fluoride toothpaste should also be encouraged.
Iron deficiency anaemia is associated with frequent infections, poor weight gain and delay in development. Iron rich foods, such as liver and red meat, are not always popular with children, so other ways of providing this nutrient may need to be found, e.g. offering paté or minced meat burgers. Children who are vegetarian must have alternative sources of iron, such as dark green leafy vegetables, pulses and nuts. Other useful sources include bread and some fortified breakfast cereals. Iron from plant sources is less well absorbed than iron from animal sources. Consuming vitamin C rich foods or drinks such as orange juice with a meal can increase iron absorption from plant sources.
CURRENT INTAKES
National survey data suggest that over recent years there has been a reduction in overall energy intake and in the percentage of energy derived from fat, with a corresponding increase in the proportion of energy derived from protein and carbohydrate (comprising starch and sugars). The average fat intake of children is in line with recommendations for adults, although their average intake of saturated fatty acids still exceeds government targets for adults. Whilst an increase in starchy carbohydrate-rich foods is to be welcomed, sugar intakes were also high in many children. Salt intakes were also above the recommended targets.
The recent national survey of young people aged 4-18 years found:
• Children eat less than half the recommended five portions of fruit and vegetables a day. In an average week, one in five 4-18 year olds ate no fruit at all.
• Over 80% of the group surveyed ate white bread, savoury snacks, potato chips, biscuits, boiled, mashed and jacket potatoes, and chocolate confectionery.
• Chicken and turkey were the most popular types of meat with over 70% of the sample eating these foods.
• Under half the boys and just over half the girls ate raw and salad vegetables (excluding tomatoes and carrots) during the 7-day study period, whilst 40% ate cooked leafy green vegetables and 60% consumed other types of cooked vegetables.
• 4% of the sample did not consume any vegetables during the 7-day survey period.
• The most commonly eaten fruits, consumed by over half of the sample, were apples and pears, followed by bananas.
• Carbonated soft drinks were the most popular drink, with three-quarters of the group consuming standard versions and less than half drinking low calorie versions.
• Generally, the quantities of foods eaten increased with age with the exception of whole milk and vegetables, which both decreased with age.
There was evidence of low micronutrient intakes or status in some subgroups, especially the older age groups as can be seen in Figure 1.
For more information on this survey, please see the attached pdf.
HEALTHY EATING GUIDELINES
Children over 5 years of age are beginning to take responsibility for their own food intake so it is important that they understand the need for a healthy diet. However, their eating habits will have been influenced by the family earlier in life, and it is difficult to change these once they are established. It is therefore important that the whole family adopts a healthy lifestyle.
The Food Standards Agency has recently provided information on the safe maximum consumption levels for oily fish (for information click here). It recommends that boys and girls under the age of 16 should not eat marlin, shark or swordfish. Boys under 16 can have up to 4 portions of oily fish a week and girls up to 2 portions (with a portion weighing 140g). The lower recommendation in girls is because substances found in oily fish e.g. dioxins can accumulate in the body and high levels may be detrimental in later life to an unborn baby.
SCHOOL MEALS
School meals can make an important contribution to the energy and nutrient intake of children. They are thought to be the best option when compared with food brought from other sources such as cafés and take-aways, although there is considerable variation in the nutritional quality of school meals. Although the Education Act of 1980 removed the obligation for schools to provide meals of a set nutritional standard, the government has recently recognised the importance of the contribution that school lunches can make to the health of children and has now re-introduced regulations on national minimum nutritional standards for schools who opt to provide lunches. These became compulsory on 1st April 2001 across England and Wales in both primary and secondary schools. Details can be found below. Separate school lunch standards have been developed in Scotland. Full details for Scottish Nutrient Standards for School Lunches are available at the link below. Children whose parents receive Income Support or Income-based Jobseeker’s Allowance are eligible for free school meals.
Some schools now offer parents guidance on the content of packed lunches, which are becoming more popular. This advice is offered as part of a ‘whole school approach’ to healthy eating through which the food consumed at school is in harmony with the principles of healthy eating taught in the classroom.
SCHOOL MILK
Subsidised school milk can be made available to children in primary schools via the EC School Milk Subsidy Scheme. This scheme allows children to purchase 250ml of milk daily at a reduced price. Details of the scheme are available from the Dairy Council.
PHYSICAL ACTIVITY
National data suggests that, with the exception of very young children (4-6 year olds), between 40-69% of children in Britain are largely inactive, spending less than one hour a day participating in activities of moderate intensity. The 2004 report At Least Five a Week, Evidence on the impact of physical activity and its relationship to health from the Chief Medical Officer recommended that children and young people have at least 60 minutes of at least moderate intensity exercise every day. It also recommended that activities that increase muscle strength and flexibility and also improve bone strength should be included at least twice a week (for more information click here).
© British Nutrition Foundation 2004 |
