Nutrition & You | Children

Nutrition & You CHILDREN

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Contents Eating Well to Grow Well Healthy Eating for Children Getting the balance right Dairy - a Matrix of Nutrients Take 3 or 5!

Supporting Bone Health Keep them Smiling Preparing a Healthy Lunchbox Top Tips for Fussy Eaters Involving your Child in Cooking Balancing Body Weight Eating Sustainably Further Reading

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This booklet is a general nutrition information resource and is not tailored to individual dietary requirements.

Eating Well to Grow Well Good habits started early can last a lifetime The early years of a child’s life are when dietary habits are formed so it’s a good time to start them on a healthy path. Your child’s energy and nutrient needs will vary depending on factors such as their gender, age, body size and activity levels while the types of food they eat may also need to be tailored to their particular stage of development.

For this reason, the Department of Health provides a different Food Pyramid and healthy eating guidance for children aged 1-4 years and for children aged 5 and over. This booklet aims to cover healthy eating recommendations for children 1 to 12 years, making it easy for parents to access information in one place. It also contains some helpful tips around fussy eating, getting your children involved in food preparation and tips on balancing that school lunchbox!

Please see our separate NDC booklet on healthy eating during the teenage years -Nutrition and You. Teens (2022).

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Healthy Eating for Children In Ireland we use the Food pyramid as a guide to choosing a healthy diet. It categorises food into groups depending on the main nutrients they contain and gives guidelines on the number of servings to be eaten daily from each group. The Food Pyramid has six food groups, but only the bottom five food groups are needed each day for good health.

As a basic rule, offer your child 3 meals and 2 to 3 healthy snacks each day.

Remember it is important that your child eats according to their own growth, appetite and activity levels so be guided by your child’s appetite to decide how much to give them.

Food Pyramid Children 1-4 years You may notice that the Food Pyramid is slightly different to that for an older child (opposite page). That is because smaller tummies need smaller portions so the serving sizes for cereals for this age group are smaller and needed more frequently.

The cereals/bread/potatoes/pasta and rice shelf is at the bottom because 4 year olds need the most servings from this shelf.

The Children’s Food Pyramid above shows examples of foods on each food shelf. It does not represent the amount of food a 1-4 year old should eat every day.

Source: Department of Health 2020

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Food Pyramid Children 5 to 12 years The same food groups are important for older children who, by the age of 5, are beginning to follow a more adult style diet. You will notice fruit and vegetables make up the largest part of the pyramid with 5-7 servings recommended for children. The cereals group is no longer on the bottom of the pyramid but the serving sizes are now larger.

Source: Department of Health 2016

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Getting the Balance Right The healthy eating guidelines also gives suggested serving sizes as well as the number of servings to be eaten daily from each group.

Cereals, breads, potatoes, pasta and rice This food group provides energy, fibre and B vitamins. Offering all wholemeal/ wholegrain choices may fill younger children up and reduce their appetite for other nourishing foods so consider offering a mix of white and wholemeal cereals and breads. For older children try to encourage them to choose wholemeal more often.

Years

Servings per day

One serving is …..

1-2

2 or 3

3-4

4 -6

½-1 slice of bread or small roll or ½ pitta pocket/small wrap 30g dry porridge or fortified flaked cereal or 1-1½ wheat biscuits ½-1 small potato or 30-40g sweet potato or yam ½ cup (30-40g) pasta, rice, noodles or couscous 1-2 crackers or unsalted breadsticks or 1 rice cake

5 to 12

3-4 Girls 4-5 Boys very active children will need more

1½ slices wholemeal bread or 1 pitta pocket 1/3 cup dry porridge oats or 1 cup flaked breakfast cereal 1 cup cooked rice, pasta or noodles 2 medium or four small potatoes 1 cup yam, plantain or couscous

Vegetables, Salad and Fruit Vegetables and fruit provide vitamins, minerals and fibre. For younger children, offer a variety of vegetables, salad or fruit chopped into small servings at every meal and as snacks. Make sure to remove any parts that could choke such as seeds, pips or stones. Enjoy a variety of colours. Limit fruit juice to unsweetened, once a day.

4

Years

Servings per day

One serving is …..

1-2

2-3

3-4

4-5

1 small fruit such as a plum, kiwi or mandarin or ½ medium sized fruit e.g. orange, apple, pear, banana or 5–6 berries or grapes (cut in quarters) 3-4 cooked vegetable or cucumber sticks or cherry tomatoes (quartered) 100ml unsweetened orange juice (once per day only) ½ cup cooked vegetables or tinned fruit or 100ml vegetable soup

5+

5-7

1 medium apple, orange, banana or pear, 10 grapes, 16 raspberries, 150ml unsweetened orange juice (once per day only) ½ cup cooked vegetables (fresh/frozen), bowl salad or homemade vegetable soup

Milk, Yogurt and Cheese These foods provide calcium for healthy bones and teeth. Breastfeeding is recommended until 2 years of age or beyond and counts towards these servings. Full fat milk should be given for children aged 1 to 2 years and low fat milk can be given to children aged 3-4 years and beyond. Skimmed milk is not suitable for children under 5 years of age.

Years

Servings per day

One serving is …..

1-4

3

5-8

3

9 to 12

5

200ml or 2x100ml milk 1 pot (125g) yogurt 2 small pots (47g) plain fromage frais 25g or 2 adult thumbs of hard cheese

Giving milk as a drink is an easy way to get one of their 3-5 daily servings

Meat, poultry, fish, eggs, beans and nuts Foods from this group are useful for their protein and iron content-important for growth and development. Red meat such as beef, lamb and pork contain iron and should be offered 3 times a week but choose lean cuts of meat and limit processed meats (e.g. sausages, ham). Include oily fish up to once per week. Good vegetarian protein sources include eggs, soya products, peas, chickpeas, beans and nuts.

(Whole nuts are not suitable for children under 5 due to risk of choking) Years

Servings per day

One serving is …..

1-2

2

3-4

3 to 4

30g cooked beef, lamb or pork, chicken, turkey or fish or 1 medium egg 35g cooked portion tofu or portion hummus ¼ cup (40g) no added sugar baked beans, peas, lentils or chick peas 1 heaped teaspoon (12g) peanut or nut butter

5+ years

2

50-75g lean cooked beef, lamb, pork, poultry or 100g cooked fish or 2eggs 100g soya or tofu or ¾ cup beans or lentils Unsalted nuts or 40g seeds

5

Fats, spreads and oils Fats, spreads and oils provide essential fats in your child’s diet but should only be used in very small amounts. A serving size is 1 teaspoon of spread on bread or ½-1 teaspoon of oil per person. Choose mono or poly-unsaturated spreads like rapeseed, olive, canola, sunflower or corn oils. Oven-bake or grill foods instead of frying.

Top Shelf Foods like sweets, chocolate, biscuits, cakes, fizzy drinks and crisps are generally high in sugar and/or fat or salt and should not be used often and only in very small amounts for young children. Small tummies need nutritious foods and top shelf goods can spoil your child’s appetite.

Remember with younger children to always cut up food to a size that your child can chew and eat safely and supervise your child when they are eating.

Cereals, cooked rice and pasta, vegetables, salad and fruit

Cheese Use two adult thumbs, width and depth to guide serving size.

Use a 200ml disposable cup to guide serving size.

Meat, poultry, fish

Reduced-fat spread

The palm of the hand, width and depth without fingers and thumbs, shows how much you need in a day.

Portion packs found in cafés can guide the amount you use. One pack should be enough for two slices of bread.

Source: Department of Health, December 2016. *An average cooked serving of meat,poultry or fish for a child 1-4 years is about one third the size of an adult’s palm of the hand.

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Oils Use ½ teaspoon oil per person for smaller children and one teaspoon for older children when cooking or in salads.

Dairy – a Matrix of Nutrients Many parents know that milk, yogurt and cheese are important sources of calcium, which is needed for the growth and development of bones in children.

However, you may be surprised to learn that these foods are natural sources of many other nutrients which are also needed for health. The ‘milk, yogurt and cheese’ food group forms part of our healthy eating guidelines.

The matrix of nutrients in milk contributes to the normal functioning of many processes in our bodies:

• Cognitive function • Thyroid function • Growth in children • Normal skin

Iodine Phosphorus

• Bone development • Healthy teeth • Muscle function

Calcium Protein

• Nervous system function • Muscle function • Blood pressure

• Energy metabolism • Reduction of fatigue • Red blood cell formation • Immune system function

• Bone development • Healthy teeth • Energy metabolism

Potassium Vitamin B2 Vitamin B12

Vitamin B5

• Muscle growth • Bone development

• Energy metabolism • Reduction of fatigue • Nervous system function • Normal skin • Normal vision • Energy metabolism • Reduction of fatigue • Mental performance

Source: EU Register of Nutrition and Health claims

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High Three or Five!

Three servings per day are recommended from the ‘milk, yogurt and cheese’ food group for those aged 1+ years with 5 daily servings recommended from age 9-12 years and up to 18 years. This increased requirement from 9 years is because of the importance of calcium during this life stage to support normal bone growth and development.

Milk is a key food for 1 to 4 year old children and breastmilk counts towards these servings. It is important to include yogurt and cheese also to help meet your child’s nutritional needs. Unsweetened fortified soya drinks can be offered if your child is allergic to cow’s milk but the Department of Health does not recommend almond, coconut, rice or other plant-based drinks for young children.

In older children, Irish research (5-12 year olds) shows that the average intake of milk, cheese and yogurt are below recommended amounts1 and a significant number of children in this age group have inadequate intakes of calcium. This survey also found that the major source of Iodine in children’s diets is milk, contributing to over 50% of intakes. Iodine is important for supporting the normal growth of children. So good to check that your children are getting their recommended amounts.

One serving includes:

Milk is perfect over

wholegrain cereal, in smoothies, or to make a hot chocolate drink.

200ml or 2 x 100mls

Yogurt is ideal over 125g or 2x smaller pots

25g

1

8

fro

fro

mag

s

ai e fr

mag

s

ai e fr

homemade granola and berries; in a smoothie or as an on-the-go snack.

Cheese is delicious on wholegrain toast or grated over a baked potato.

Irish Universities Nutrition Alliance (IUNA) (2020) National Children’s Food Survey II

Supporting Bone Health The health of our bones is determined mainly by factors that we cannot control such as genetics, gender and age. However, there are factors that we can control such as the foods we eat and the type of physical activity that we do.

Childhood and adolescence are important stages for bone growth and development. In fact, about half of an adult’s bone mass is built up during this time. Looking after our bones in our younger years can have a positive impact on our bone health for life.

Diet A balanced diet which provides bone-friendly nutrients such as calcium, protein and phosphorus is important for our bones health.

Vitamin D is another key nutrient for bone health and is found in foods like oily fish, eggs and fortified foods including fortified dairy products. It is known as the sunshine vitamin because it is made by the action of sunlight on the skin.

However, in Ireland we don’t get adequate sunshine so the Department of Health has recommended that children aged one to four take a vitamin D-only supplement of 5 micrograms (µg) as drops or liquid every day from Halloween to St Patrick’s Day. For older children, consider a 5-10 microgram (510μg) supplement every day from Halloween to St Patrick’s Day if they don’t eat vitamin D rich foods.

Activity Regular participation in ‘weight-bearing’ activities is also essential for bone health. Weight-bearing activities are activities that put the full weight of our body on our feet and legs.

Examples of fun ‘weight-bearing’ activities for children: • Dancing • Running • Gymnastics • Tennis • Basketball It is recommended that from 2 years children should be active at a moderate to vigorous level for at least 60 minutes every day. Muscle-strengthening, flexibility and bone-strengthening exercises should be included as part of these guidelines three times per week.

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Keeping them Smiling Although primary teeth fall out and are replaced with permanent teeth, it is essential that children look after their first teeth. Healthy primary teeth have clear roles in speech and eating but are also needed for guiding permanent teeth into their correct positions. It is important, therefore, to set a good foundation by teaching and encouraging your child to look after their dental health.

Nutrition tips Encourage your child to eat a balanced diet, basing food choices on the healthy eating guidelines (pages 1-4).

• Encourage drinking from a cup by the child’s first birthday and do not dip soothers in sugar, honey or anything sweet before giving it to the child.

• Frequent consumption of sugary foods and drinks is the primary cause of tooth decay. Therefore, limit how often your child consumes sugary foods and drinks.

• Dietary acids (e.g. from fizzy drinks, fruit juices) can result in dental erosion.

Remember to choose drinks wisely. Milk and water are suitable choices, often referred to as ‘tooth-friendly’ drinks.

• Certain nutrients play a role in dental health. For example, calcium and phosphorus contribute to the maintenance of our teeth. Milk, yogurt and cheese are natural sources of these nutrients.

Practical tips • Ensure your child brushes their teeth twice daily, once before bedtime and at one other time during the day.

• Supervise brushing until your child is seven years of age. Teach your child to brush their teeth using gentle and very short sideways movements.

• Ensure your child has regular dental check-ups.

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Preparing a Healthy Lunchbox A healthy, yet appetising, lunchbox for children may often be viewed as a challenge. However, with a few simple tips, you can rest assured knowing your child is heading off to school with a nutritious, satisfying lunch.

Avoid your child getting bored with packed lunches by introducing variety, offering a range of tastes and presenting food in interesting ways.

• Base choices on the Food Pyramid guidelines as each food group includes many options (pages 1-2).

• If introducing something for the first time, try it at home first. It is important that the lunchbox is healthy but your child must also enjoy it.

• Involve your child in preparing their school lunch. This will help encourage responsibility and an interest in what they eat.

• School days can be hectic! So set aside some extra time during the weekend to plan for the week ahead.

Visit ndc.ie/nutrition/lunchbox-tips for a sample lunchbox weekly planner

It is important that children drink enough fluids throughout the day.

Water and milk are considered the best choices and are suitable between meals and snacks.

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Cathy’s Top 10 Tips for Fussy Eaters We know feeding your child is not always plain sailing so we have asked Senior Paediatric dietitian and weaning expert Cathy Monaghan for some practical advice on fussy eating and how to involve your children in food preparation and cooking.

Weaning went well, but now your child has other ideas....

Growth slows down from around your baby’s first birthday and appetite can level off at this time. Even if your child ate well up until age 1 year, it is not unusual to feel they don’t eat enough during the toddler years. Also, as your child grows, they can become fearful of new or unfamiliar foods.

Here are 10 tips to help you and your child with meals and snacks. Before making any changes, send yourself an email describing how meals are at present – are they stressful, what foods are on offer or eaten, is there pressure to eat, how enjoyable is the meal? You could rate these from 1 – 10 (1 being least stressful, 10 being very stressful).

Try my tips below and look back over your email in a few months and see what has improved!

1. You provide, they decide. You are responsible for what is on offer and when it is on offer. Your child is responsible for if and how much is eaten. Have at least one food on offer that you know your child will eat, but you don’t need to provide an alternative meal.

2. Food is more than nutrition. A successful meal is one that you all enjoy. Don’t judge success based on what has been eaten. If a meal is enjoyable your child will look forward to the next one.

3. Eating is a sensory experience. Tasting is the final piece of the puzzle. Focus on the seeing, touching and smelling and the eating will eventually look after itself.

4. Create opportunities for your child to interact with food with no pressure to eat it. Find ways to involve your child in food preparation (see overleaf).

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5. Don’t bribe your child to eat. Instead use adjectives to make food sound interesting. Are the strawberries juicy? Are the carrots crunchy or soft? Play eye spy with colours – Something green, the peas! Something orange, the carrots for example!

6. Messy food play helps your child interact with food in a relaxed way. Paint with vegetables, a teddy bears picnic, build towers with carrots and cucumbers.

7. Children believe what they hear. Try and not let your child hear you speak negatively about their eating habits. You would never say ‘they are terrible at cycling (or maths or football)’, the same logic applies to food!

8. End meals on a positive so your child doesn’t feel like they have failed. ‘Thanks for sitting with us’, ‘you are great with your beaker’, ‘thanks for setting the table’.

9. Demonstrate the behaviour you want to see. Sit and eat together, put the phones / distractions away. Dedicate 20 minutes to the meal. Make it a place your child likes to be.

10. Have a pre meal ritual – TV off and music on, do Wordle together - anything that helps you settle and reconnect after your busy day.

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Involving your Child in Cooking Tips for cooking with kids: •

Your kids will learn to love cooking if you relax and have fun together. Start with basic recipes that you know they enjoy to eat. Mixing flour, milk and eggs for pancakes or making smoothies with yogurt and fruit for example are suitable for all ages to help out with.

•

Cooking with kids will take longer, so set aside a little extra time. Grandparents are great for sharing cooking skills!

•

Expect extra mess! Put a tray underneath their work station or adapt the recipe if needed. Try leaving the clean up until the end.

•

A damp cloth under their mixing bowl or chopping board will help prevent slips and spillages.

•

Buffet style meals create jobs for everyone. Fajitas are a good example of this – grating the cheese, heating the beans, getting the yogurt, meat, corn and lettuce ready. Share knowledge about food hygiene – washing hands, keeping raw and cooked foods apart.

Work with the child in front of you and adapt accordingly but some ideas for building skills include 3–5-year-olds can: •

Identify, gather and mix ingredients together, wash vegetables, spin salad spinners.

5–7-year-olds can: •

Learn cutting and chopping skills with age-appropriate utensils under supervision, weigh and measure ingredients, roll out pastry, set the table, peel cooled hard boiled eggs or grease cake tins!

8 -12-year-olds can: •

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Read recipes and pick new ones, bake for friends and family, gather ingredients, use peelers, open cans and start to cook elements of your family meal.

Balancing Body Weight Maintaining a healthy body weight is a balancing act. Food and drinks provide energy (calories) and this energy is used by the body – for example, during physical activity. However, if energy intake is greater than energy used, over time, this will result in weight gain.

Useful tips •

Watch portion sizes! Serve portion sizes relative to your child’s age and size – not adult-sized portions.

•

Monitor and limit intake of ‘treats’. However, try not to ban these foods as this may make them more appealing.

•

Encourage your child to be active.

•

Be enthusiastic about healthy choices. Praise and compliment good decisions.

•

Ensure all adults who care for your child are aligned regarding your child’s diet and activity.

A positive body image Children need to be aware that there is more to their body than how it looks.

It is important that children appreciate that healthy choices are necessary for overall health and wellbeing, not just body weight.

Remember, behaviour and comments from influential adults in a child’s life (e.g. parents, carers, teachers) are hugely important. Be positive and lead by example.

Be aware of not discussing your or somebody else’s weight in front of children as they can pick up on negative comments. The key is health, not weight.

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Eating Sustainably Many parents want to know more about being environmentally friendly including how to eat more sustainably. A sustainable diet also needs to be something we can maintain in the long term and that keeps us properly nourished.

Therefore, they should be:

1.

2.

3.

4.

Nutritionally adequate, safe and healthy Culturally acceptable and accessible Economically fair and affordable Environmentally protective (respectful of biodiversity and ecosystems)

The emphasis on each of these pillars needs to be adjusted so that there is harmony between them.

Balancing each one in relation to the other supports sustainability (Figure 1).

Figure 1: The components of a sustainable diet2

Tips for Sustainable Eating as a family •

Reduce food waste. Check your fridge before you go shopping or ask your children to help, explaining why it’s important

•

Use children size plates and bowls and portion size guidance on page 6. You can always give them more if they are still hungry!

•

Include an abundance and variety of fruit and vegetables

•

Boost nutrient intakes with moderate amounts of dairy

•

Include legumes and nuts; moderate amounts of eggs, poultry and fish; and small amounts of red meat

•

Include safe tap-water as the fluid of choice

Sustainable Irish Dairy – Top Class Irish dairy cows graze on luscious green grass for most of the year - making the quality and flavour of our dairy products internationally renowned. Irish dairy has one of the lowest carbon footprints internationally. This is due to its efficient, grass-based production system. Irish data now shows a 10% reduction in the carbon footprint per kg of milk, with efforts continuing to improve.

Irish farmers look after their cows very well and it has been shown that cows under good care produce the best quality milk. Specific practices are also in place to ensure the highest quality and safety of milk production. It is worth pointing out that in Ireland and the European Union, there is a total ban on the use of artificial hormones for milk production.

2. FAO and WHO. 2019. Sustainable healthy diets – Guiding principles. Rome.

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Further Reading The National Dairy Council www.ndc.ie Irish Nutrition and Dietetic Institute - Factsheets www.indi.ie/all-food-facts-and-fact-sheets Safefood www.safefood.net Department of Health- The Food Pyramid (2016) and The Child’s Food Pyramid (2020) www.healthyireland.ie Dental Health Foundation www.dentalhealth.ie Teaching your children to be active https://www2.hse.ie/wellbeing/teaching-your-children-to-be-active Health Service Executive-Daily meal plans for 1-4 years www.mychild.ie

Moo Crew is the National Dairy Council’s education programme for primary school pupils, helping children to learn about the importance of healthy eating, physical activity and the ‘milk, yogurt and cheese’ food group. To find out more: visit To find out more: visit www.moocrew.ie or email schoolmilk@ndc.ie The School Milk Scheme is managed by The National Dairy Council and funded by the Department of Agriculture, Food and the Marine with the support of the European Union.

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National Dairy Council The Studio, Maple Avenue, Stillorgan, Dublin A94 HY83, Ireland NDCIreland

Published August 2022

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