Toddler nutrition

Growth patterns in children

Where a baby is largely consuming energy/food to grow, a child is also eating to cover the cost of movement and maintaining a larger body mass.

Some of the growth and developmental characteristics in early childhood include:

• An increase in muscle mass
• A drop in body fat, though girls tend to hold more body fat than boys
• Between 2-3 years of age, the spread of body fluid between various compartments is similar to an adult
• A slowing of the phenomenal growth rate associated with infancy, but a bigger growth in stature
• Almost complete development of the brain (75 %) by 2 years
• Thirst reflex becomes fully established between 2 and 3 years of age
• Ability to self-regulate energy is less effective now and parental guidance is required
• Increased suspicion of food and consequent fussiness

So while toddlers and pre-schoolers may not be growing as much as they did, they are busy people and still need nutritious food to cover both growth and also, now, activity. The next biggest growth phase is in early adolescence.

Recommended intakes: things have changed

Just a little nutritional information before we embark into the land of eating. Most of us are familiar in some way with the term RDA, but there are a few things you should know about intakes.

Firstly, when we refer to the RDA (recommended daily allowance) of a nutrient, this is based on the amount of a nutrient to meet nearly all of a person’s needs, within a given population. Many of these were updated recently, for example there is now no difference in the calcium RDA for pregnant women and those that aren’t pregnant.

So now that you have the background, see what you think of the data so far. Keep in mind that any collection of data will have problems, but you can still see general trends.

How are they faring?

• Calcium intake in little ones is fine, though not in older children
• Here’s no surprise - veggies are well below par
• Kid’s aren’t eating enough cereals and whole grains
• Fibre seems to be on the mark

Well there is of course good and bad news. I am sure you were expecting that, especially if you have a fussy eater. In an ideal world, our children would eat as we want them to, it would be SO much easier if they did. But, this just isn’t always the case. If your child is falling below the ideal servings for veggies, just know that you aren’t alone and, as long as you are offering predominantly healthy food, you are doing the right thing.

Still, the news isn’t all bad and at the end of the day you have to look at each individual child.

Energy in the balance

Interestingly, about 6% of energy in our children’s diets comes from non-alcoholic beverages (this excludes water and milk). We are seeing a rise in the amount of sweet drinks, such as cordials and fruit juices, and sometimes fatty drinks, such as flavoured milk. Research suggests that obese pre-schoolers consume twice as much energy from non-core drinks as non-obese children.

The whole issue of ‘over-nutrition’ suggests that just reducing energy intake by a small percentage (similar to the amount consumed in non-core beverages), can significantly impact positively on health outcomes in the long term. Do you see a trend? Yes, think hard about the cordial and juice in the fridge.

Weight issues

Unlikely this will be news to you, given the media attention on our growing waistlines, and for good reason. Figures show that around 20–25% of Australian children are either overweight or obese, and the 9-16 year age group appears to be most at risk. The most common consequences of obesity in childhood (and adolescence) are poor body image and low self-esteem. The health impacts of childhood obesity include high blood pressure and blood cholesterol, raised blood sugar levels, Type II diabetes, joint problems, sleep apnoea, asthma and a fatty liver.

Food groups (ticks and crosses):

On the whole, our children are doing well with food groups such as meat/fish/poultry and dairy, but let’s take a look at some of the other food groups. You may not be surprised at which ones children aren’t doing so great in, but just how troublesome the figures are might be more eyebrow-raising. 

• Fibre: Good news, it seems the intake of fibre has increased over the years.
• Vegetables: If you include potato, only 22% of 4-8 year olds meet the recommended servings (this falls to 3% if you take potato out).
• Fruit: Fruit intake drops with age to just 1% of 14-16 year old boys and girls consuming the recommended serves per day (excluding fruit juice).
• Cereal: Very few children reach the required servings of cereals (3-4/d). In fact only 20% of 4-8 year olds are meeting this.

Nutrient ups and downs

Fat

• Total fat intake is just slightly above the recommended level
• But, our old foe, saturated fat, is above recommended levels by about 4%

Calcium

• 2-4 year olds are, by and large, meeting their RDI.
• However, some boys and girls aged 4-8 are not and, across the board, girls appear to be most at risk of not getting enough calcium. 65% of boys and only 45% of girls met the EAR for calcium. This drops to 50% and a scary 11% for ages 12-13 years. This may in part be due to age-related perceptions of dairy products. It’s good to note that we reach our peak bone density upon puberty, so getting enough calcium is essential in childhood – it is what sets you up with the stores for the rest of your life.

Iron

• Almost 100% of 2-8 year olds are reaching their EAR for iron, though some 11% of girls aged 14-16 may not be getting enough iron. Adolescent girls that have begun menstruating need a greatly increased amount of iron (from about 8 mg/d up to 15 and then 18 mg/d in the child-bearing age bands).

Sodium

• If you look at the data, it looks like all our children are meeting the adequate intake of sodium, but it is highly likely that, in fact, our children are consuming more sodium than is required. Let’s look at it another way. The dietary guidelines recommend that we all choose foods low in salt. If this were the marker we were comparing the results against, it is likely that the figures would be very different, and in fact few children are consuming diets low in salt.

Water

• For our 2-4 year olds, non-core drinks such as fruit juice, cordials and sports drinks represented 25% of total energy from drinks.
• Interestingly, obese pre-schoolers are more likely to have a far greater energy intake from such drinks. I am sure you will see more on this in the media in the coming months. 12% of energy comes from confectionary and non-alcoholic beverages (7%). To frame the impact of this, it is estimated just a 10% drop in energy intake could make a significant difference to obesity rates in children.

What does this mean?

Don’t feel bad if your child simply refuses to eat fruit, veggies or meat, because you are not alone! You can lead a horse to water… Certainly, as parents, we don’t need to feel any more guilt over our parenting style, but we may need to tidy up the edges a little.

Simply put, we need to keep the home for healthy stuff and leave all the lollies, juices, cakes and pies for those ‘special’ occasions… parties. Until your child hits their teen years, you still have reasonable control over what they eat, particularly in the home. If you have let things slip, like we all do at some time or another, and are reflecting on the state of your cupboards, newly filled with chips and biscuits, then slowly cut back. Leave fruit and healthy options in easy-to-access places and encourage children to snack on fruit, healthy crackers, yoghurt and so on.

If you do nothing else except limit sweetened beverages, products with added sugar and takeaways, then you will make a huge difference. Keep in mind that just a 10% drop in energy from junk can make a significant difference to body composition and health.

Stick with a good old-fashioned diet, limit the smartly packaged, sleekly designed, nutrient-devoid products, and go with the food you can put your hand on and eat.