Ruth Charles
Consultant Paediatric Dietitian
Nutrition for 6-12 year olds
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
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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 2004
http://www.dohc.ie/publications/pdf/primary_schools.pdf?direc
t=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.
Bone health Vitamin D
Active 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 margarines
Some fortified brands of soya milks, yogurts and desserts – check the label
A few fortified breakfast cereals – check the label
Dried skimmed milk
Fortified yoghurts
Eggs
Oily 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
Ruth Charles, Consultant Paediatric
Dietitian.www.nutrikids.ie
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.
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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
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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
sources
Fluids
Time to eat
Need 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 meal
Enough allocated time?
Important part of the school day.
With increasing age, more time spent in
school.
Translating recommendations to
practice
Energy
Carbohydrates: Cereals, grains, bread,
Potatoes. Wholegrain varieties
Sandwiches, 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
Ruth Charles, Consultant Paediatric
Dietitian.www.nutrikids.ie
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 lunch
Healthy lunch box – putting ideas into practice:
Wholemeal bread with cheese slice and tomato + 1 banana + sugar free squash
Pitta bread with cooked ham, low-fat mayonnaise lettuce and cucumber + orange segments + milk to drink
Burger bun with chicken, relish, lettuce and grated carrot + dried fruit + yoghurt + water to drink
Toasted wholemeal bread with cooked beef, tomato and cucumber + small apple + milk to drink
Cooked pasta with tuna, lettuce, tomato and carrot + 2 mandarins + yoghurt + unsweetened pure fruit juice
Salad 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 drink
Crackers with cheese slices, sliced peppers, grated carrot +apple and orange segments + water to drink
Cooked rice with cooked peas, carrot and chicken pieces + dried fruit + unsweetened fruit juice
Hummus sandwich + Banana + unsweetened fruit juice
Drinks
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