Nutrition Information

School Age, 5-11 years

Why is nutrition important for a school aged child? Good nutrition supports optimal growth, development and health. Children establish eating patterns and physical activity behaviors at an early age which may prevent health conditions such as anemia, poor nutrition, obesity, eating disorders and dental caries. Promoting lifelong behaviors to reduce the risk of chronic disease (such as: cardiovascular disease, diabetes mellitus, hypertension and osteoporosis) is vital at this age.

My Child’s Plate
It is recommended to feed a child three meals and 2-3 planned snacks each day. This is the time that children are learning the importance of good nutrition and establishing healthful habits. A child’s diet should be rich in whole grains, fruits and vegetables, calcium rich foods and lean proteins. Added fats and sweets should be limited at this age. It is recommended that children receive zero servings of sugar sweetened beverages. See http://www.choosemyplate.gov for details of what a child’s plate should look like.

Since kids are establishing lifelong eating habits at this age, it is important that the eating environment be pleasant. The following guidelines can be used to encourage an enjoyable setting at meal and snack times for school-age children:

• Provide structured meal times. Plan times and create a schedule for meals. Snacks also should be planned for and served at the table at scheduled times. This may prevent a child from becoming too hungry in between meals.
• Eat meals only at the table. Avoid distractions like TV or computer games which may lead to overeating. Research has shown that there is an increased correlation between family meals and psychosocial well-being and improved dietary intake (Eisenberg 2004; Neumark-Sztainer 2003).
• Encourage social interaction by paying attention, by sitting together, talking together, and praising good table manners.
• Food should not be used as a reward or as punishment.

My Child’s Weight
BMI (Body Mass Index)– What does this term mean? You may have heard your child’s doctor mention this. BMI measures a child’s weight for his height or in other words, how proportionate he or she is.

Children should have their BMI (body mass index) calculated at each doctor’s visit. If your child’s BMI plots greater than the 85th%tile he or she may be considered overweight. If the BMI plots greater than the 97th%tile your child may be obese. If this is the case, it would be helpful for your child to meet with a Registered Dietitian or enroll in a weight management program. Ideally, your child’s body mass index should follow close to the same percentile throughout early childhood and into adolescence.

Tips for increasing Physical Activity

• Have your children walk or ride their bike to school
• Reward your child’s good behavior with a trip to the park
• Have your child dance or jog in place during commercial breaks of his/or her favorite TV show
• Be intentional about scheduling time to be outside on the weekends. Encourage you children to go outside rather than sitting in front of a computer or television screen.
• Jump on a trampoline
• Purchase pedometers for each member of the family. Have a competition to see who can achieve the most steps in a day.
• Walk the dog.
• Join a sports team.

Remember that reducing the time your child spends being inactive is a step in the right direction.

Important Nutrients for my Child’s Health

The Dietary Guidelines for Americans for fluids for children are as follows:

• Children aged 4 to 8 years need 56oz water per day
• Boys aged 9 to 13 years need 80oz water per day
• Girls aged 9 to 13 years need 70oz water per day

Calcium Intake
Many children do not receive adequate amounts of calcium which may be related to milk being replaced by soft drinks. When calcium rich foods are not adequate in the diet, it places children at a high risk for developing osteopenia or osteoporosis. Encouraging children to select nonfat or low fat calcium rich foods and beverages can promote good bone health and prevent bone disease. (JADA 2003)

Vitamin D Intake
The problem of Rickets used to result from a diet that was not adequate in Vitamin D in the pediatric population. Now dairy products are fortified with vitamin D, decreasing the rate of rickets.

Vitamin D synthesis occurs when the child is exposed to sunlight, however due to a concern of skin cancer, children often are not limited to sun exposure. Therefore higher rates of Vitamin deficiency in children are being noted. The current recommendation is to provide vitamin D supplementation to all children and adolescents who do not receive >200IU/day of fortified foods. Foods which contain Vitamin D are dairy products, fortified cereals, fatty fish and fortified juices.

Fiber
A diet rich in fiber prevent help the school aged child from symptoms of constipation. Fiber containing foods such as fresh fruits and vegetables and whole grains are healthful and may aid in the prevention of overweight and obesity.

Fiber needs can be calculated using the formula of the child's age plus 5 g fiber per day, up to 20 g fiber per day at 15 years of age (Daniels 2008).

Kid Friendly Recipes – see recipe section – format on recipe cards-RECIPES BELOW

Frequently asked questions

How many times a day should my school aged child be offered food?
Children should be offered 3 meals a day and 2-3 snacks in between. Keep in mind that going more than 4 hours without food may trigger hunger. This could lead to overeating!

What things are important to look at on a nutrition label?
Serving size is one of the most important things to look at on a nutrition label. Also, notice the serving size per container which indicates how many servings are in the entire box or package of food. Also notice the amount of fat and calories. Saturated fats should be <10% of total calories per day. Trans- fats should be avoided if possible.

What are some healthy snacks for my child?
If your child is a toddler, some healthy snacks might include small sandwiches, graham crackers with cream cheese, banana or apple slice, frozen banana on a stick (dip in fudge sauce, role in flaked coconut and freeze), muffin, pudding, canned fruit, yogurt with fruit (add honey to increase calories). Be aware of hazardous foods that may cause your toddler to choke. These include “bullet” shaped foods like grapes, nuts, hotdogs, etc. For a school-aged child, try snacks like cheese on crackers or toast, banana bread, fruit muffin, rice cake, pita bread stuffed with meat salad or veggies, frozen fruit juice bars, celery stuffed with cheese or peanut butter, string cheese or cheese cubes, fresh fruits, and apples. Also, the American Academy of Pediatrics recommends 4-6 ounces of juice per day for children 1-6 years of age and 8-12 ounces of juice per day for children 7-18 years of age.

How many fruits/vegetables does my child need a day? Are there any suggestions on how to fit them into a picky eater’s diet?
Children from 1-6 years old should have 2-4 servings of fruit and 3-5 servings of vegetables per day. Ideas for sneaking fruits and veggies into your child’s diet include serving fruits and vegetables with peanut butter, yogurt dip, or vegetable dip, or serving vegetables hidden in carbohydrates like green beans within mashed sweet potatoes. Also, try giving children raw carrots dipped slightly in ranch dressing for some added flavor. A good rule of thumb would be to eat the rainbow- 5-9 servings of fruits and vegetables a day because they keep them full longer and are packed with vitamins and minerals with low caloric content.

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Adolescent

In order to attain optimal growth, teens need lots of calories and nutrients. Adolescence is a stage in life where growth is happening at a rapid rate. At the climax of a teen’s growth nutrient needs often double which means eating healthful is very important.

Not only are teens growing in weight and height during adolescence, but they are also becoming more independent, making food choices of their own. Therefore, this is a vital time for establishing healthful eating behaviors which will help prevent obesity. Obesity could later lead to things like heart disease, hypertension, diabetes and other diseases. (McAnarney, 1992).

Keeping the Balance
Food gives a teen’s body fuel in the form of calories, which are a kind of energy. The teenage body needs a certain amount of calories every day just to function, breath, walk around and do basic stuff. But if you’re active, your body needs an extra measure of calories or energy. If you’re not very active, your body won’t need as many calories. Whatever your calorie needs, if you eat enough to meet that need, your body weight will stay about the same or grow appropriately. If you eat more calories than your body needs, it may be stored as excess fat.

• Food energy > physical activity = weight gain
• Food energy < physical activity = weight loss
• Food energy = physical activity = weight maintenance.

BMI Body Mass Index–What does this term mean? BMI measures a child or adolescents’ weight for his or her height or in other words, how proportionate he or she is.

Teens should have their BMI (body mass index) calculated at each doctor’s visit. If the BMI plots greater than the 85th%tile he or she may be considered overweight. If the BMI plots greater than the 97th%tile the teen may be obese. If this is the case, it would be helpful to meet with a Registered Dietitian (insert link to outpatient part of website). Ideally, your child’s body mass index should follow along or near the same percentile throughout early childhood and into adolescence.

It is recommended to have your doctor calculate and plot your BMI at routine visits.

Healthy Eating Tips for Teens

• Fill half of your plate with fruits and veggies – http://www.choosemyplate.gov
• Limit the amount of times you eat outside the home. When eating out, choose foods that are grilled, baked or broiled rather than fried.
• Avoid sugar sweetened beverages
• Pick up fruit at snack times
• Pack your lunch rather than purchasing it at school
• Consume 3 servings of low fat dairy products each day
• When preparing foods, try not to add fat such as butter, animal fat or oils.
• Put snacks on a plate rather than eating from the bag or box
• Make a colorful plate. The more colorful fruits and veggies you can add to your plate the better!

Many teens’ diets are lacking in adequate vitamins and minerals. Adolescents' diets may be low in vitamins A and E, folate, iron, zinc, magnesium, and calcium (Lino, 1999; Munoz, 1997; Cavadini, 2000). Eating a variety of fruits, vegetables, whole grains and low fat dairy products will help avoid nutrient deficiencies.

The Teen Athlete
Teens are often engaging in physical activity which demands good nutrition and adequate hydration. Following these guidelines may lead towards the best athletic performance:

• 4 hours prior to exercise drink about 2-3 milliliters per pound of body weight.
• During exercise choose a drink that contains sodium, potassium and carbohydrate. This will help add energy while replacing electrolytes lost through sweat.
• After exercise, remember to drink plenty of fluids. It may take the body up to 24-48 hours to replace sweat losses in full.
• Pre- event meals should be balanced containing carbohydrate, protein and minimal fat. These meals are important to prevent low blood sugars, fuel muscles and settle the stomach.
• Be sure to eat foods which are routinely consumed to prevent intolerance or poor digestion which may vary among individuals.

The Female Athlete Triad
Female athletes may experience problems such as eating disorders, amenorrhea (an interruption of the menstrual cycle) and osteopenia/osteoporosis. Amenorrhea can be associated with eating disorders which may be a long term contributor to decreased bone mineral density. If a teen is showing signs of disordered eating (restricting calories beyond what is needed to maintain weight, binge/purge episodes, demonstrating fear of certain foods or food groups) then it may beneficial to have a doctor refer him or her to a registered dietitian as well as a mental health provider. (Clark, Nancy, Nancy Clark’s Sports Nutrition Guidebook. 4th Ed.)

Frequently asked questions

How much fiber does my child/teen need?
Up to 18 years of age, we recommend age + 5 grams of fiber. For example, if your child is 4 years old, then he/she would need 9 grams of fiber per day. If your teen is 16 years old, it is recommended he/she consumes up to 21g/day fiber. So if you pick a cereal with 5 grams of fiber for your 10-year old child, your already one third of your way to the recommended amount!

My child/teen’s pediatrician says his BMI is indicative of overweight. What does this mean? How can I help?
BMI stand for Body Mass Index. BMI measures body fat based on a person’s height and weight. BMI-For-Age growth charts are used to assess the ideal BMI range for a child’s age. If BMI is higher than normal for age, then it is indicative of overweight because there is more body fat than necessary in the body. Eating more fruits, vegetables, and low fat meats and dairy is a good way to help improve your child or teen’s BMI. However, ask your doctor or dietician about the best diet plan for your child or adolescent.

I see nutrition supplements for kids at the grocery. Are these appropriate?
If your child or teen is eating a well balanced diet, with all the different food groups, nutrition supplements may not be necessary. If certain food groups are not included in the family’s diet, such as vegetarian families, then nutrition supplements may be necessary for your child. Iron is a common concern in young children and sometimes a multivitamin with iron is recommended. However, consult with your pediatrician or dietitian before beginning the usage of nutrition supplements.

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