Healthy Eating for Kids and Teens (page 5)

Soda leeches calcium from growing bones. Teenage girls, who often live on diet sodas in an effort to stay slim, are four times more likely to break a bone than teen boys. Fizzy water and fruit juice drinks are a far healthier choice.

Good nutrition is the bedrock of lifelong health, and it begins in infancy. Yet all too soon, your kids are bombarded by messages that counteract your efforts. Between peer pressure and the constant television commercials for junk foods, getting children to eat well might seem more futile than fruitful. However, there is a lot that parents—and children—can do to develop and maintain healthy eating habits that last well into adulthood.

Start my child off eating well

Because the childhood impulse to imitate is strong, the best move you can make to start your child off on the right dietary foot is to be a role model, so that when your youngster asks to taste what you're eating, your plate is filled with healthy selections from the new food guide pyramid. If you're asking your child to eat vegetables and fish while you graze on potato chips and soda, your actions will override your good intentions. (See Helpguide's Healthy Eating: Guide to New Food Pyramids and Tips for a Healthy Diet.)

Children will develop a natural preference for what they eat most often and enjoy. The challenge is to make healthy choices appealing. When one resourceful mother called whole-wheat graham crackers "cookies," her daughter considered them a treat. By the time her child tasted a white sugar cookie at a friend's house (at around age 5), the child found it overly sweet and rejected it. (Bonus: as a young woman, she had strong teeth with no decay.)

To promote healthy childhood eating:

• Have regular family meals. Children need routines. Knowing dinner is served at approximately the same time every night and that the entire family will be sitting down together is comforting, which also enhances appetite, and provides a perfect opportunity for your children to share what's on their minds.
• Get kids involved. Children enjoy helping adults grocery shop, selecting what goes in their lunch box, and preparing dinner. It's also a chance for you to teach them about the nutritional values of different foods, and (for older children) how to read food labels.
• Make a variety of healthy foods available. Keep plenty of fruits, vegetables, whole grain snacks and healthful beverages (bottled water, milk, herbal tea, occasional fruit juice) around and easily accessible so kids become used to reaching for them when they're hungry.
• Let them choose. Don't make mealtimes a battleground by insisting a child clean the plate, and never use food as a reward or bribe.

Changing dietary needs

As children develop, they require appropriately-sized portions of the same healthy foods adults eat, along with more vitamins and minerals to support growing bodies. This means:

• Whole grains (whole wheat, oats, multi-grain, rye, rice, millet, quinoa);
• Fresh fruits and vegetables;
• A source of calcium for growing bones (milk, yogurt, or substitutes if lactose intolerant);
• Healthy proteins (fish, eggs, poultry, lean meat, nuts and seeds).

Refined white sugar and white flour are not necessary to a healthy children's diet—and your child will get enough of these from whatever sweets and fast foods they do eat.

Contrary to what many parents believe, kids don't need large amounts of fat because they're "burning it off" by being active. But the kind of fat they're eating does matter. Butter on vegetables, avocados and corn chips (made with sunflower or safflower oil), pecans or walnuts are far preferable to French fries, donuts, candy bars or cheeseburgers.

Infants

Babies grow faster than at any other stage of life, tripling their birth weight by their first birthday. This time also sets the stage for many later eating patterns and emotional relationship with food, so it is important to pay attention to both what and how you feed your baby. Whether you breast-feed or bottle-feed your infant, holding, cuddling and soft, gentle sounds and expressions are an important part of the feeding process, as they engage both mother and baby in secure attachment (see Helpguide’s Parenting: Attachment, Bonding, and Reactive Attachment Disorder).

Breast-feeding

In the first year of life, breast milk is the ideal food. Check with a nurse practitioner or La Leche League for useful tips to make breast-feeding a successful and easy process. Moms who need to be away from their babies can use a breast pump to express and store milk in the refrigerator or freezer, for Dad or other caretaker to bottle-feed the infant. A sick baby or one with many allergies will often do much better with breast-milk than formula. If you are unable to produce enough milk, ask your pediatrician about breast-milk donations (see references and resources for Milk Bank locations).

Bottle-Feeding

If breastfeeding is not an option, infant formula contains virtually the same mix of protein, carbohydrates, fat, water, vitamins, minerals and calories that your baby needs to grow at this crucial stage of development. If you choose to bottle-feed:

• Be sure to use sterile bottles, clean water, and follow instructions on amount of formula.
• Do not dilute formula, or your baby will not be getting adequate nutrition.
• To avoid bottle tooth decay , be sure to remove the bottle when feeding is complete. If your baby falls asleep with the bottle, natural sugars in the milk can cause decay in new or forming teeth.
• For the same reason, don’t let your toddler carry around a bottle of milk, juice, or any other liquid besides water while playing.
• Avoid introducing cow’s milk until after one year old, if at all (some children are allergic to cow’s milk and do better with goat’s milk, or soy or rice milk).

Weaning your baby

Current wisdom says breastfeeding for the first year of life confers numerous health benefits to your child. Beyond that, it's all right to continue for as long as you and your child feel comfortable. Bottle-fed babies can begin to transition to a “sippy-cup” when they are able to hold and manage the container. Healthy eating habits over a lifetime can develop by introducing new experiences as signs of maturity and exciting development, and will make it easier for your child to let go of baby things being held for emotional support.

Introducing solid foods

At 4 to 6 months of age, when your baby has learned to sit up, control head movement and swallow food rather than pushing it out, it's time to begin adding solid foods to baby's diet.

• Start slowly: just one or two spoonfuls of food in the beginning.
• Introduce one new food at a time. Add another new food after four or five days. Waiting allows the baby to get used to new flavors and allows you to identify any problem foods easily if allergic reactions occur.
• Begin with rice cereals. Rice is less likely than other grains to cause an allergic reaction. Mix it with breast milk or infant formula to provide a good balance of protein, carbohydrate, and fat and to serve as a good source of iron.
• Hold the baby during feeding. Babies need to be reassured that this new experience is safe.

Toddlers and young children

For children ages one to five, the following is a general guideline. (Always consult your pediatrician for special dietary considerations, such as food allergies, or if you are raising your child as a vegetarian).

• Fruits and vegetables. Two servings each per day. These may be given as snacks, such as apple or carrot slices. Also try slipping in veggies in the form of soups.
• Whole grains. Four daily servings. Can include buckwheat pancakes or multigrain toast for breakfast, a sandwich on wheat bread for lunch and brown rice or another whole grain as part of the evening meal.
• Milk and dairy. Three servings, or one pint of whole milk per day. Cheeses, yogurt and milk puddings are useful alternatives.
• Protein. Two servings a day. Encourage your child to try a variety of foods from this category, such as turkey, eggs, fish, chicken, lamb, baked beans, lentils. NOTE: Nuts, although an excellent source of protein, are not a good choice for children under five due to the risk of choking.

What constitutes a "serving"? Here are some examples:

• 1 or 2 small cooked broccoli spears
• 5 to 7 cooked baby carrots
• 1/3 to 1⁄2 cup of melon
• 5 to 7 strawberries
• 1 cup (8 fl. oz.) yogurt or milk
• 1/3 to 1⁄2 cup of brown rice or mashed potatoes
• 1⁄4 cup ground meat such as turkey
• 1 or 2 chicken drumsticks

Additional vitamins and minerals, such as Vitamin C and iron, are sometimes recommended for young children. Check with your child's doctor to be certain your child's diet is adequately meeting the recommended nutritional needs for this age group.

What is a healthy diet for school-age children?

By the time children enter secondary school, their diet more closely resembles the new food guide pyramid for adults. For kids aged 5-12, the key word is variety. Creative serving ideas (see Fruits and Vegetables section) will go a long way towards maintaining the healthy eating habits established in the first years of life.

Typical minimum servings are:

• Vegetables: Three to five servings per day. A serving might be one cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, raw or cooked.
• Fruits: Two to four servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, such as an apple, banana or pear.
• Whole grains: Six to 11 servings per day. Each serving should equal one slice of bread, 1/2 cup of rice or 1 ounce of cereal.
• Protein: Two to three servings of 2-3 ounces of cooked lean meat, poultry or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of lean meat.
• Dairy products: Two to three servings per day of 1 cup of low-fat milk or yogurt, or 11/2 ounces of natural cheese.
• Zinc: A new study indicates that 20mg of zinc five times a week may improve memory and school performance, especially in boys. Good sources of zinc are oysters, beef, pork, liver, dried beans and peas, whole grains, fortified cereals, nuts, milk, cocoa and poultry.

What are the special needs of adolescents?

This is growth spurt time: kids gain about 20% of adult height and 50% of adult weight during adolescence. Most boys double their lean body mass between the ages of 10 and 17. Because growth and change is so rapid during this period, the requirements for all nutrients increase. This is especially true of calcium and iron.

Eating habits, however, are pretty well set by now, and if your child's choices are less than ideal, it's a challenging time for a course correction; teens have other priorities. The best way to make teen dietary changes is by presenting information about short-term consequences that they can relate to: appearance, athletic ability, popularity and enjoyment of life, because these are more important to most teens than long-term health. For example:

Calcium will help you grow taller during your growth spurt. It also makes you measurably stronger. Iron will help you do better on tests and stay up later without being as tired. Carrots will make you a better driver, and will make me more comfortable lending you my car, and so on.

When you do speak of long-term consequences, link them to the things that teens care about—particularly body image. For instance, “Have you ever seen old men and women that are bent over when they walk? Have you seen old men and women that are strong and active? One of the biggest differences was how much calcium they got every day when they were your age..." It's a fine line between teaching and preaching, but will pay big health dividends down the line.

Dr. Greene, child health expert

Ways to increase teen calcium intake include:

• Eating more yogurt, dark-green vegetables (collard greens, spinach, turnip greens, kale), cheese, milk, pudding, sesame seeds, tofu, bok choy (Chinese cabbage), canned non-boneless salmon and sardines, and cottage cheese.
• Cutting back on soda consumption, which leeches calcium from bones. Teenage girls, who often guzzle soda in an effort to avoid food and stay thin, are four times as likely as boys their age to break a bone.
• Calcium supplements.

Persuading children to eat more fruits and vegetables

You may have been told not to play with your food, but making mealtime playful can mean healthier eating for you and your kids! Here are some creative ways to build more fruits and vegetables into your child's daily diet:

• Top a bowl of whole grain cereal with a smiley face: banana slices for eyes, raisins for nose, peach or apple slice for mouth.
• Create a food collage. You can use broccoli florets for trees, carrots and celery for flowers, cauliflower for clouds, and a yellow squash for a sun. When you're all finished, you can eat your masterpiece!
• Make frozen fruit kabobs for kids using pineapple chunks, bananas, grapes and berries.
• Go food shopping with your children. Take them to the grocery store or Farmers' Market to let them see all the different sizes and colors that fruits and vegetables offer. Let them pick out a new fruit and vegetable to try.
• Try fruit smoothies for a quick healthy breakfast, or afternoon snack.
• Keep lots of fresh fruits and veggies washed, available, and in a place where children know to look when they want a snack. Easy fruits and vegetables to grab and eat on the run include apples, pears, bananas, grapes, figs, carrot and celery sticks, zucchini slices. Add yogurt or a tub of nut butter or tahini for extra protein.

How can I get my picky eater to enjoy a wider variety of foods?

Picky eaters are going through a normal developmental stage, exerting control over their environment along with concern about trusting the unfamiliar. This often goes along with the “separate compartmented plate” stage, where children don’t like one type of food to touch or mingle with another. Just as research has shown that it takes a number of repeated impressions before advertising convinces an adult consumer to buy, it takes the average child 8-10 presentations of a new food before he or she willingly accepts it.

If your child is otherwise healthy, eating only a few select foods for a little while will not have any adverse effect. So, rather than insist your child eat a food that is being rejected (the worst step you could take), try some of the following:

• Offer a new food only when your child is hungry and rested.
• Present only one new food at a time.
• Make it fun (see above); a game, a play-filled experience. Cut the food into unusual shapes.
• Serve new foods with favorite foods to increase acceptance.
• Eat the new food yourself; children love to imitate.
• Limit beverages. Picky eaters often fill up on liquids instead.
• Limit snacks to two per day.
• Encourage your child to help with food preparation.

What can I do when my children clamor for junk food?

If you've been following the guidance and suggestions given so far, your kids are probably well on the way to lifelong healthy eating habits. It pays to stay vigilant and involved, however. Parent activism can make the difference in school nutrition. Some school policies now ban soft drinks and junk food altogether; others have installed vending machines that offer healthy alternatives. In addition to the Ten Steps to Bringing Healthy Foods into Schools, try some of the substitutions below:

Anne Collins, weight loss expert

Collins offers 15 creative, practical suggestions for parents to help kids slim down which summarize much of the information above:

• Provide a range of healthy snacks that kids can grab for themselves: a variety of whole wheat cereals, different breads, fresh fruit, fat-free yogurt, etc.
• If they love junk food, cook your own at home rather than allowing them take-outs. Use lean steak to make burgers, serve on a whole wheat bun with lots of salad. Make your own oven chips by cutting potatoes into thick chips, spray with light cooking spray and cook in a hot oven.
• If they eat at school, find out what choices are available and talk to them about the best choices to make.
• Fast foods need not be fattening: buy a pizza base and put your own low-fat toppings.
• Mix some fat-free milk with whole milk and keep it in a jug.
• Make your own popcorn using half the normal amount of oil.
• If you know your child loves a particular dish that is high in fat, don't cut it out completely. Include it in his/her diet every couple of weeks as a treat.
• Make a healthy "fizzy" drink by mixing one-third fruit juice with two-thirds fizzy water.
• Get a set of ice-pop molds, fill them with fruit juice and freeze for a low calorie snack.
• Encourage them to use the blender to make their own shakes. Use any soft fruit, banana, peaches, raspberries, strawberries, blend with fat-free milk, rice milk or almond milk.
• Make your own trail mix: dried fruits, sunflower seeds and pumpkin seeds, walnuts, almonds or pecans.
• If you see your children eating something fattening, don't make a fuss and don't expect them to be perfect. Remember the most important thing is to teach them long-term, good eating habits.
• Don't compare your child with anyone else.
• Constantly talking about weight/dieting, your own or your child's, can be damaging. There are many cases of eating disorders in teenage girls who have grown up in a household where the mother is an obsessive dieter.
• Ideally, introduce good eating habits to your child as early as possible, but remember it is never too late to start. Kids adapt to new ideas very quickly.

To Learn More: Related Helpguide Articles

• Healthy Eating: New Food Pyramids and Tips for a Healthy Diet
• Healthy Fast Food: Healthy Restaurant Eating
• Healthy Fats: Choosing the Right Fats for your Diet

• Healthy Recipes: Guide to Fast, Delicious Meals
• Nutrition for Women: Lifelong Healthy Eating

Related links for children's nutrition

General Information

The New Food Guide Pyramid – Article aimed at kids explains exactly how much of each serving children needs to eat to stay healthy, according to the new food guide pyramid. (Kids Health)

Infants and Babies

Feeding Infants: A Guide for Use in the Child Nutrition Programs (PDF) – A lengthy, illustrated handbook on child development and all aspects of infant nutrition. (US Department of Agriculture (USDA))

Developmental Chart for Feeding Infants – Describes the stages of infant growth with feeding guidelines for the first year of life. (Academy of General Dentistry)

La Leche League – Information and support concerning breastfeeding, with locations of local chapters, consultants, breast pumping, and other information. (La Leche League, International)

Milk Bank – For mothers who want to donate surplus breast milk for sick babies, or for mothers who need to access milk, these are the locations of milk banks in North America. There are guidelines for donations elsewhere on their website. (Human Milk Banking Association of North America)

Breast-feeding: When to Quit? (commercial site) – Andrew Weil, MD, offers his counsel about this crucial stage in infant nutrition. (DrWeil.com)

Zinc appears to help boys learn – Cites a recent study showing that zinc enhances children's cognitive abilities, and indicates a higher minimum requirement than previously stated. (news-medical.net - content from 6,000 daily news sources, with rotating monthly commerical sponsors)

Zinc Nutrition and Mental Performance of Children – Grand Forks Human Nutrition Research Center reports on zinc and children's brain development. (USDA)

Healthy Eating, Part V (commercial site) – Good news for vegetable haters everywhere! How to start your baby off loving veggies for life. (DrGreene.com)

Children

Healthy Eating, Part II (commercial site) – What foods do children need? What foods should be avoided? How to differentiate healthy from unhealthy choices for children. (DrGreene.com)

Healthy Eating, Part III (commercial site) – The five greatest motivators for preschool children to eat healthy foods. What you as a parent need to know. (DrGreene.com)

Picky Eaters – A child development expert known as "Dr. Dad" offers humorous and insightful advice for coping with kids' refusal to eat certain foods. (DrKutner.com)

What's the Right Weight For Me? – A child's guide to understanding body type, calories, exercise, and how to maintain optimal weight. (Kids Health)

Pre-Teens and Teens

Is Dieting OK for Kids? – Explains why children generally do not need to diet the way adults do, and when dieting can become dangerous to one's health. (Kids Health)

Teenage Obesity - Weight Loss for Kids (commercial site) – Extensive, practical suggestions for parents to help teenagers lose weight and maintain good health. (AnneCollins.com)

Additional online resources for children's nutrition

Eating tips for children (1) - babies – Comprehensive piece detailing how, when and what to feed your child in the first year of life. (Better Health/Victoria, Australia)

Eating tips for children (2) - young toddlers – Parental concerns and unique challenges of feeding toddlers. (Better Health/Victoria, Australia)

Eating tips for children (3) - older toddlers – Tips to get finicky eaters on the right track. (Better Health/Victoria, Australia)

Eating tips for children (4) - preschoolers – Recommendations for kindergarten meals and new home meal routines. (Better Health/Victoria, Australia)

Eating tips for children (5) - primary school – The importance of breakfast, dealing with peer pressure around food, exercise and snack ideas. (Better Health/Victoria, Australia)

Caring for Kids-Healthy Eating – From vitamins to vegetarianism, suggestions to help your child develop healthy eating patterns for life. (Canadian Pediatric Society)

Children's Nutrition and Learning – How eating habits, nutritional deficiencies and economic status affect a child's learning potential—and what we can do about it. (Make Way for Baby!)

Daily Values vs. Nutritional Recommendations – Can you trust the "Nutrition Facts" label on foods? Important tips to help you provide adequate nutrition for your teen. (Children's Nutrition Research Center at Baylor College of Medicine)

Other resources that we used in writing this article

Healthy Eating, Part I (commercial site) – How important is good nutrition? Dr. Greene lays the foundation for healthy childhood eating patterns squarely in parents' plates. Let them imitate your healthy choices, he says. (DrGreene.com)

Healthy Eating – What are the best strategies for kids' nutrition? Have regular family meals. Serve a variety of healthy foods and snacks. Be a role model by eating healthy yourself. Avoid battles over food. Involve kids in the process. (Kids Health)

Feeding Infants – The basics for breastfeeding and beginning solid foods. (National Network for Child Care)

Healthy Food Choices for School-Age Children – The recommended food groups adapted for children ages 5-12, including healthy substitutions for fried, salty and sugary foods. (American Academy of Pediatrics)

Healthy Eating, Part IV (commercial site) – Motivators for school age children and adolescents. The special needs of teens, and how to avoid all-too-common anemia from junk food diets. (DrGreene.com)

FAQ picky eaters (PDF) – Defines picky eating and explains what parents can do to encourage children to broaden their food choices. (Carolina Pediatric Dysphagia)