Nutrition for 6-12 year olds

Ruth Charles
Consultant Paediatric Dietitian
Nutrition for 6-12 year olds
Ballinderry Clinic, St. Francis Hospital, Mullingar, Co. Westmeath.
Key growth periods in childhood
• Birth-age 1
• Puberty
Growth in early years
Puberty growth spurt
Growth factors
Genetics: parental height
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 1999 2004
t=1 2003
Meal planning: Special considerations
• Food allergy or intolerance: peanut free (egg,
• 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
– Low GI foods
– Exercise and food
• Food Allergy:
– Reaction type/severity
– What food involved
Bone health: Calcium
• 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
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
Cultural food customs
Dental Health
• 1 in 5 Irish Children are overweight/obese
• Personal and parental accountability is
• More children will die of obesity associated
medical problems without national strategies.
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
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
• Self esteem & confidence
• Cardiovascular health
Fuel for sport
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
Translating recommendations to
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
Sugar free usually means sucrose free (fructose/glucose)
Fat: PUFA/MUFA better for health than saturated/trans
October 20, 2011
Ruth Charles, Consultant Paediatric
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
Menu planning
•Food allergy or intolerance
•Cultural food customs
•Modified consistency (puree,
mash, liquid)
•Bone health
•Dental health
•Athletic/active children
Free resources
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
White roll with mashed hard boiled egg, lettuce and cucumber + handful of grapes + sugar free squash/milk to
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
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

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