In general, it is the parents’ job to monitor what their child eats, while the child is in the best position to decide how much to eat. Normally, healthy and active children’s bodies do a good job of “asking” for just the right amount of food, although their minds may lead them astray when choosing which foods to eat.
You can easily overestimate the amount of food your child actually needs, especially during the younger years of middle childhood. Youngsters of this age do not need adult-sized servings of food. However, if you are unaware of this, you might place almost as much food on your child’s plate as on your own. As a result, your child must choose between being criticized for leaving food on his plate, or for overeating and running the risk of obesity.
Weighing your children occasionally is one way for you to monitor your youngsters’ nutrition. There is rarely a reason for you to count calories for your children, since most youngsters control their intake quite well. As the middle years progress, children’s total energy needs will increase and thus their food intake will rise, especially as they approach puberty. Between ages seven and ten, both boys and girls consume about 1,600 to 2,400 calories per day, although caloric needs obviously vary considerably even under normal circumstances. Most girls experience a significant increase in their growth rate between ages ten and twelve and will take in about 200 calories more each day, while boys go through their growth spurt about two years later and increase their food intake by nearly 500 calories a day. During this time of rapid growth, they will probably require more total calories and nutrients than at any other period in their lives—from calcium to encourage bone growth, to protein to build body tissue.
At most ages boys require more calories than girls, primarily because of their larger body size. But appetites can vary, even from day to day, depending on factors like activity levels. A child who spends the afternoon doing homework, for example, may have fewer caloric needs than one who plays outdoors after school. Every child’s caloric needs are different.
Pediatricians evaluate children’s growth and build by means of standardized growth charts and body mass index (BMI). Growth charts show whether a child falls within the normal range of height and weight for her age. Children whose weight or height is above the 85th or below the fifth percentile should be examined by a doctor to determine whether further evaluation is needed. Pediatricians also will watch for fluctuations in children’s weight, which may mean something has changed and put them on the path toward gaining excess weight.
Body mass index is a calculation of your child’s weight relative to height. A BMI above the 85th percentile means overweight, while children above the 95th percentile are considered obese, which increases their risk of chronic diseases such as heart disease and diabetes. The BMI percentile that defines severe obesity is 120% of the 95th percentile. If your child’s BMI is between the 85th and 95th percentiles, her excess weight may be fat or muscle. Growth charts and BMI tell only part of the story because neither method measures body fat. Children and adolescents who are particularly athletic with unusually muscular or lean builds may have a high BMI without having excess fat or being obese. In some obesity clinics, as many as 10% to 15% of children fall into this category. Also keep in mind that there are small differences between African American and white children; at the same BMI measurement, African American children and teenagers tend to have more muscle and bone mass and less body fat. However, almost all children and adolescents with a BMI above the 95th percentile have too much body fat, regardless of their ethnicity or muscularity.
Some parents wonder how it is possible for 17% of 2- to 19-year-olds to be obese when only 5% of the population should have a BMI above the 95th percentile. The BMI charts were based on children and teens studied before 1988, when not as many youth were obese. At that time, only 5% of children and teens were obese.
If your child is overweight because her frame size is increased, reassure her that her extra weight is not fat and encourage her to be physically active to maintain her muscle tone. Also, be actively involved in any discussions with your pediatrician and your child about your child’s weight. To prevent worries about body size, parent and child need to accept the child’s body type. Other members of the family may have a similar build. If you focus inappropriately on weight alone and pester your child to lose weight, she may develop a distorted body image and risk an eating disorder. It’s estimated that 70% to 80% of girls perceive themselves, whether rightly or wrongly, as too fat. Experts warn that a misperception of body image may be partly fueling the current obesity epidemic, with inappropriate dieting followed by rebound weight gain.
Choose to Be Happy
Many adolescents, particularly girls, become deeply unhappy when they realize that they are never going to be shaped like supermodels or earn multimillion-dollar contracts as movie stars.
Help your daughter feel comfortable with who she is. Reassure her that real beauty is more than skin deep. Help her develop her skills and talents and emphasize her positive attributes. Offer her female role models who have made the most of their talents, achieving intellectual and humanitarian goals or raising healthy, balanced children, instead of trading on their looks for superficial success.
Family eating habits determine what your child will learn to eat and enjoy. Here are some ways you and your family can limit fat and cholesterol in your diets:
Keep fresh fruits and vegetables available.
Serve whole-grain bread and cereals.
Rely on low-fat milk and low-fat yogurt. Select cheeses that are lower in fat, for example.
Include starchy foods (potatoes, pasta, rice) in your meals.
Avoid high-fat and high-calorie toppings, including butter, margarine, sour cream, and gravy. Instead, use herbed cottage cheese, grated parmesan cheese, or low-fat yogurt as toppings.
Serve lean meats, such as chicken, turkey, fish, lean beef cuts (lean hamburger, top loin, top round, eye of round), and lean pork cuts (tenderloin, loin, chops, ham). Cut away visible fat and remove the skin from poultry.
Select margarine and vegetable oils (canola, corn, olive, sunflower, and soybean oils).
Choose frozen fruit bars, angel food cake, or low-fat frozen yogurt instead of rich, creamy desserts.
When cooking, use nonstick vegetable sprays to cut down on added fat.
Choose fat-free cooking techniques, such as baking, broiling, poaching, grilling, or steaming when preparing meat, fish, and poultry. Do not use butter or margarine when preparing or serving vegetables.
Serve vegetable-based and broth-based soups. Choose low-fat milk when making cream soups.
How can you ensure that your child is well nourished?
Here are some tips to keep in mind when planning and preparing meals for your family.
Your child should consume a variety of foods from the five major food groups. Each food group supplies important nutrients, including vitamins and minerals.
The five food groups and typical minimum servings:
Vegetables: 3-5 servings per day. A serving may consist of 1 cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, chopped raw or cooked.
Fruits: 2-4 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, like an apple, banana, or pear.
Bread, cereal, or pasta: 6-11 servings per day. Each serving should equal 1 slice of bread, 1/2 cup of rice or pasta, or 1 ounce of cereal.
Protein foods: 2-3 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: 2-3 servings per day of 1 cup of low-fat milk or yogurt, or 1 1/2 ounces of natural cheese.
Fiber is a carbohydrate component of plant foods that is usually un-digestible. It is found in foods like fruits, vegetables, whole-grain breads, cereals, brown rice, beans, seeds, and nuts.
In adults: Increased fiber has been linked with a reduction of chronic gastrointestinal problems, including colon cancer, irritable bowel syndrome, and diverticulitis.
In children: Fiber’s only proven benefit is its ability to ease constipation—providing bulk that can promote regular bowel movements, soften the stools, and decrease the time it takes food to travel through the intestines. But since food preferences and eating habits often get searly in life, and since high-fiber foods contain other nutrients, parents should include these foods in children’s daily diets.
Your child needs protein so their body can grow and function properly. This includes building new tissues and producing antibodies that help fight infections. Without essential amino acids (the building blocks of protein), children would be much more susceptible to serious diseases.
Protein-rich plants—such as dried beans and peas (legumes), grains, seeds, and nuts—can be used as valuable sources of protein. Other protein-rich foods include meat, fish, milk, yogurt, cheese, and eggs. These animal products contain high-quality protein and a full array of amino acids.
Keep in mind, however, that while red meat and shellfish are rich in protein and an important source of iron, they can also be high in fat and cholesterol as well. So, your child should consume them only in moderate amounts. Select lean cuts of meat and trim the fat before cooking. Likewise, remove skin from poultry before serving.
Humans cannot live without fats. They are a concentrated source of energy, providing essential fatty acids that are needed for a variety of bodily processes (metabolism, blood clotting, and vitamin absorption).
However, high fat intake—particularly a diet high in saturated fats—can cause problems. Saturated fats are usually solid at room temperatures and are found in fatty meats (such as beef, pork, ham, veal, and lamb) and many dairy products (whole milk, cheese, and ice cream). They can contribute to the buildup of plague in blood vessels and lead to heart disease later in life. A diet rich in saturated fats also can increase blood cholesterol, particularly in people who have inherited a tendency toward high cholesterol levels.
After age two: Children should be served foods that are lower in fat and saturated fats. Chances are that your child’s favorite foods are higher in fat than is desirable. Healthy ating means relying more on low-fat, low-cholesterol foods like poultry, fish, and lean meat (broiled, baked, or roasted; not fried), soft margarine (instead of butter), low-fat dairy products, and low-saturated-fat oils from vegetables, while limiting egg consumption.
As a general guideline, fats should make up less than 30% of the calories in your child’s diet. No more than about 1/3 or less of those fat calories should come from from saturated fat, with the rest coming from unsaturated (that is, polyunsaturated or monounsaturated) fats. These healthier fats are liquid at room temperature and include vegetable oils like corn, safflower, sunflower, soybean, and olive.
Some parents find the information about various types of fat confusing. In general, oils and fats that come from animals are saturated. The simplest place to start is just to reduce the amount of fatty foods of all types in your family’s diet.
Limit the amount of sugar in your child’s diet to to moderate levels. Sugar has plenty of calories, but dietitians often call them “empty calories” because they have very little additional nutritional value. Even so, many children consume sugar in large amounts, usually at the expense of healthier foods. When children drink sodas, for example, they are usually leaving the milk in the refrigerator; when they eat a brownie, they may be overlooking the bowl of fruit, a good source of complex carbohydrates, on the kitchen table.
Table salt, or sodium chloride, may improve the taste of certain foods. However, researchers have found a relationship between salt in the diet and high blood pressure in some people.
High blood pressure afflicts about 25% of adult Americans and contributes to heart attacks and strokes.
The habit of using extra salt is an learned one. So, as much as possible, serve your child foods low in salt. In the kitchen, minimize the amount of salt you add to food as you prepare it. Try using herbs, spices, or lemon juice instead. Take the salt shaker off the dinner table, or at least limit its use by your family.
Because salt acts a preservative, processed foods often contain large amounts of it. Salt-rich foods may include processed cheese, instant puddings, canned vegetables, canned soups, hot dogs, cottage cheese, salad dressings, pickles, and potato chips and other snacks.
Nutrition is important to normal growth processes, and thus you should make an effort to ensure that your child consumes a well-balanced diet. Your child’s need for calories rises during times of rapid growth, gradually increasing as she moves through middle childhood into puberty.