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Transcript
School ‘NutriAgent’ Handbook
To effectively improve and monitor the eating environment at school, teachers
and parents should take the following actions:
 Reinforce nutritional knowledge.
 Use various monitoring tools skilfully to achieve constant improvements in
the eating environment at school.
 Communicate with the school, parents, students and food suppliers
(including lunch suppliers and tuck shop operators) frequently to improve
the nutritional quality of lunches or snacks available at school and strengthen
cooperation between parents and schools.
1. Reinforce nutritional knowledge
To monitor and improve the healthy eating environment at school, surveillance
team members should have basic nutritional knowledge and know how to use
various monitoring tools properly. This chapter is intended to deepen the
nutritional knowledge of the Nutri-agents through giving key introductions on
the following nutrition-related aspects:

Nutritional Guidelines on School Lunch for Primary School Students

Nutritional Guidelines on Snacks for Primary School Students

Frequently Asked Questions (FAQs) on Healthy Eating

How to read nutrition labelling
1.1 Key points of Nutritional Guidelines on School Lunch for Primary School
Students
The Guidelines mainly aim to ensure that the lunch taken by schoolchildren can
achieve energy balance, prevent them from consuming too much fat, sugar, and
salt while increasing fibre intake.
An ideal and healthy lunch should be able to meet one third of the daily
nutritional needs of a schoolchild. In accordance with the local Food Guide
Pyramid promoted by the Department of Health, a healthy lunch should have
grains and cereals as the main ingredients, with dishes mainly comprised of
vegetables and some meat.. A lunch box should provide grains and cereals,
vegetables, and meat (and its substitute) in the ratio of 3:2:1 by volume.
© October 2007 Department of Health, Government of the HKSAR
All rights reserved.
6
School ‘NutriAgent’ Handbook
The recommended lunch serving sizes for junior and senior primary students are
as follows:
Food
group
Recommended Recommended
Examples of 1 serving
quantity for
quantity for
P.1-3 students P.4-6 students
Grains and
cereals
At least 4
servings
At least 5
servings





Vegetables
At least 1
serving
At least 1
serving




Meat,
poultry,
fish, eggs,
and beans
1- 2 servings
1 1/2 - 2 1/2
servings





© October 2007 Department of Health, Government of the HKSAR
All rights reserved.
Rice, cooked = 1/5 bowl = 40 g
Rice noodle, cooked = 1/5 bowl =
40 g
Egg noodle, cooked = 1/4 bowl =
40 g
Spaghetti or macaroni, cooked =
1/3 bowl = 50 g
Bread, without skin = 1/2 slice =
20 g
Leafy vegetables (e.g. lettuce),
raw = 1 bowl = 55 g
Leafy vegetables (e.g. Chinese
cabbage, spinach), cooked = 1/2
bowl = 85 g
Gourds (e.g. wax gourd,
zucchini), cooked = 1/2 bowl =
90 g
Mushrooms, cooked = 1/2 bowl =
80 g
Beef, pork, chicken, or fish,
cooked = 40 g
Shrimp, cooked = 8 small = 40 g
Whole egg, cooked = 1 large =
50 g
Tofu, firm = 1/3 bowl = 85 g
Beans (e.g. Hyacinth beans,
kidney beans), cooked = 1/2 bowl
= 90 g
7
School ‘NutriAgent’ Handbook
Fruit
At least 1/2
serving
At least 1/2
serving






Fats and
2 servings
oils
maximum
(Used
during food
preparation
and
cooking
processes)
2 servings
maximum


Orange (unpeeled) = 1 medium =
130 g
Apple (unpeeled) = 1 medium =
106 g
Banana (unpeeled) = 1/2 large =
68 g
Grapes = 1/2 bowl = 80 g
Fresh orange juice = 3/4 cup =
186 g
Dried fruit e.g. raisin = 1/2 pack =
42 g
Vegetable oils (e.g. corn, peanut,
canola or olive oil) = 1 teaspoon
= 4.5 g
Salad dressing (e.g. mayonnaise,
Thousand Island or Italian
dressing) = 1 tablespoon = 15 g
*Remark 1:Suppliers should supply at least 21/2 servings of fruits during a 5-day week.
Remark 2:1 cup or 1 bowl = 240 ml
To promote schoolchildren have a higher intake of fibre and lower intake of
fat/oils, lunch suppliers should observe ALL of the following good practices
when serving ALL school lunches:



Vegetables are supplied every day
Only vegetable oils (such as corn oil, canola oil, olive oil, and peanut oil) in
limited amount are used for cooking
All visible animal fat and excess oil used in cooking are removed before
serving
© October 2007 Department of Health, Government of the HKSAR
All rights reserved.
8
School ‘NutriAgent’ Handbook
Lunch prepared for schoolchildren should follow the principle of “low-salt, low-sugar,
and low-fat” and “high-fibre”. Common lunch food item categories are shown in the
following table:
Encouraged Food Items
(ALL of the following
food categories should
be included in AT LEAST
ONE menu choice
on ALL school days)

Whole grains (e.g. red
rice, vegetable rice,
corn rice, or
wholemeal bread)

Reduced fat dairy
products or other
calcium-rich food
items (e.g. tofu, soy
milk with calcium
fortified, and spinach)
Limited Food Items
(ANY of the following items
should not be served on
more than 2 school days per
week)
Grains and cereals with
added fat or oil (e.g. fried
rice, fried noodles, baked
rice, or noodles with
sauce)
 Fatty cut of meat and
poultry with skin (e.g. ox
belly, spare ribs, chicken
wings, chicken, duck, or
goose with skin)
 Whole fat dairy products
(e.g. whole fat milk,
regular cheese, and
yoghurt)
 Processed or preserved
meat, egg and vegetable
products (e.g. BBQ pork,
bacon, ham, sausages,
preserved mustard green,
and pickled cucumber)
 Sauce or gravy with high
salt or fat content *(e.g.
black bean sauce, black
pepper sauce, and
fermented soybean curd
paste)

Strongly Discouraged
Food Items
(The following items should
not be included in ALL menu
choices)
Deep-fried food items
(e.g. deep-fried pork
chop, French fries,
deep-fried chicken leg,
spring roll, and deep-fried
dumpling with curry stuff)
 Food items with added
animal fat, plant-based of
saturated fat, and
hydrogenated fat (e.g.
butter, lard, margarine,
palm oil, or coconut oil)
 Desserts or beverages
with more than 10 grams
or 2 teaspoons of added
sugar in each serving (e.g.
tetra-pack drinks, fizzy
drinks or, sweetened
green tea)
 Items with very high salt
content (e.g. salted fish,
salted egg)

* Remark: It is recommended that sauce or gravy with high salt or fat content should be served sparingly and
separately.
© October 2006 Department of Health
All rights reserved.
9
School ‘NutriAgent’ Handbook
1.2 Key points of Nutritional Guidelines on Snacks for Primary School Students
“Snack” is defined as a small amount of food taken between meals and not required
for every children. However, due to a small stomach volume and high activity level,
the three main meals may not meet children’s daily nutritional needs. Children are
always hungry and need snacks at mid-meal time.
Nutritious snacks help children have adequate intake of energy and nutrients, promote
growth and development. Nevertheless, snacks should be served only when children
are hungry at mid-meal time and not spoil the appetite of children for the next meal.
Snacks should:

Belongs to the food pyramid

Be served in small amount

Be served 1.5-2hours apart from the main meals

Be served with beverages and water is the major drink
Users may refer to the opinions offered in this chapter for reviewing and deciding the
categories of food items and beverages sold to students. In addition, parents may refer
to the following grouping when buying and preparing food for children as snacks:
 Snacks to Choose More –Food and beverages rich in one or more of the nutrients
while low in fat, added sugar, and salt should be encouraged as the major
choices.
 Snacks to Choose in Moderation – Food and beverage items contain one or more
nutrients but also have fat, added sugar or salt, so that their consumption should
be limited. These food items should be taken not more than 2 to 3 times per
week.
 Snacks to Choose Less – Food and beverage items that are low in nutritional
value or high in fat, added sugar or salt. These items are strongly discouraged
against the risk of chronic diseases, e.g. obesity, heart disease, diabetes, and high
blood pressure, etc.
© October 2006 Department of Health
All rights reserved.
10
School ‘NutriAgent’ Handbook
Food
Group
Grains
and
cereals
Snacks to Choose More
Snacks to Choose
in Moderation
Snacks to Choose
Less

White bread, whole
wheat bread, including
whole wheat bread,
wholemeal bread with
added nuts and raisin
bread
Unsweetened or
low-sugar breakfast
cereals and cereal bars
High-fibre or plain
biscuits and crackers
Boiled corn or corn
kernels
Unsweetened or
low-sugar oat drinks


Fresh vegetables (e.g.
cucumbers, carrots,
cherry tomatoes)
Green salad (with
minimal amount of
low-fat salad dressing
or plain yoghurt)

Pickled or

preserved
vegetables,
salted seaweeds
Salad with
whole fat salad
dressings
Fresh fruit
Dried fruit without
added sugar (e.g.
apricots, prunes and
raisins)
Baked dried fruit chips
e.g. apple chips
Fruit platter or salad
(without or minimal
amount of low-fat salad
dressing)
Freshly blended fruit

Dried fruit with 
added sugar or
canned fruit in
syrup (even if
served without
syrup)
Sweetened fruit
juices
Canned fruit in
juice
Canned fruit in
syrup (if
served with
syrup)




Vegetables 

Fruit





© October 2006 Department of Health
All rights reserved.

Refined
breakfast
cereals with
added sugars or
fat/oil(e.g.
cocoa bubbles
and frosted
corn flakes)
Plain sponge
cake







Biscuits coated
with chocolate
or sandwich
biscuits
Cream-filled
buns, cakes
Chocolate
muffins,
pastry, cookies
Instant noodles
French fries,
deep-fried
sweet potatoes
Crisps and
chips
11
School ‘NutriAgent’ Handbook
juice without added
sugar, 100% natural
fruit juice
Meat,
beans,
nuts





Dairy
products


Canned tuna in water
without added salt, or
lean fresh meat (e.g.
beef, chicken breast,
turkey slices) as
sandwich filling
Boiled egg
Bean curd dessert
without added sugar
Unsweetened or
low-sugar soy milk
Unsalted nuts or beans
e.g. almonds, peanuts,
cashew nuts, peas


Low-fat or skimmed
milk without added
sugar
Low-fat yoghurt or
cheese e.g. plain
yoghurt or fruit yoghurt
without added sugar,
low-fat cheese






Food Group
Unhealthy Snack Choices
Food items high
in oil, sugar and
salt




© October 2006 Department of Health
All rights reserved.
Chicken wings
Ham, bacon
and sausages
Pan-fried or
steamed
dumplings
Minced fish
“Siu mai”
Salted roasted
nuts and beans
Bean curd
dessert with
added sugar
Sweetened soy
milk


Whole fat milk, 
yoghurt and
cheese
All deep-fried
food items(e.g.
deep-fried
chicken wings,
fish fillets,
“fish ball”)
Beef or pork
jerky
Ice cream, ice
blocks
Sauces e.g. curry sauce, black pepper sauce, soy sauce
Confectionery (e.g. candies, chocolate)
All sugary fizzy drinks or tetra-pack drinks
Cordials and 3-in-1 instant drinks
12
School ‘NutriAgent’ Handbook
1.3 FAQ on healthy eating
About Food
1.
A:
Is potato vegetable?
Potato is usually classified into the “Grains and Cereals” group because it is
high in carbohydrate but low in fibre. Other plant foods in the “Grains and
Cereals” group include corn, taro, sweet potato, and carrot, but they are also
counted as “Vegetables” for their high fibre content. Pumpkin is in the
“Vegetables” group only.
2.
Would low fat dairy products (e.g. milk, yoghurt or cheese) be less
nutritious?
A: Dairy products are rich in protein and calcium and calcium is good for
children’s development of teeth and bones. In fact, the protein and calcium
content are similar in low-fat and whole fat dairy products, excepts fat content is
lower in the low-fat ones. To promote healthy weight and heart health, it is
recommended toddlers aged 3 year-old or above to have low-fat dairy products
and have skimmed ones from the age of 6 year-old.
3.
A:
Is chicken healthier than beef?
Actually, the nutritional profile is different between red meat likes pork, beef
and lamb and white meat like fish and skinless chicken. For example, red meat
is richer in iron, which promote the production of red blood cells, whereas white
meat has less fat than the red ones. Therefore, both types have their respective
advantages. Under the healthy eating principle of “Having good variety of
foods”, we just have to choose lean red meat or white meat in appropriate
amount and prepare them in the way that is low in fat, salt and sugar, this is part
of our healthy balanced diet.
4.
What does “serving/portion” mean? What is the difference between
“serving/portion” and “serving/portion size”?
“Serving/portion” is an indicator commonly used by the nutritional profession in
describing how much food an individual should take from different food
categories daily; whereas “serving/portion size” is for describing how big a
“serving/portion” is. For example, we should eat 3 servings of vegetables every
day; and 1 serving of vegetables means approximately 1/2 bowl of cooked
vegetables, or 1 bowl of uncooked vegetables.
A:
© October 2006 Department of Health
All rights reserved.
13
School ‘NutriAgent’ Handbook
5.
A:
Is drinking long-boiled soup or marrowbone soup good for our body?
Many people think that long-boiled marrowbone soup is rich in calcium that
would benefit the development of bone. In fact, a children aged 6-12 year-old
requires 800-1000mg of calcium everyday and a bowl of long-boiled
marrowbone soup only contains about 2mg of calcium. In addition, the boiling
process not only cannot release the calcium from the pig’s bones into the soup;
but a massive amount of fat (especially saturated fat) in the bone marrow will go
into the soup and thus not recommended to have. Parents is suggested to make
clear soup with gourds, vegetables, legume, fish or lean meat.
About Fats and Oils
1. What are the healthy kinds of edible oil?
A: Healthier choices of plant oil, such as olive oil, canola oil, or corn oil, may be
used. They contain more unsaturated fat. Yet bear in mind that all kinds of oil
contains same amount of calories, excessive intake may also cause obesity and
affect our health.
2. What is palm oil? Is it easily found in food?
A: Palm oil is extracted from the fruit of palm trees. Although it is a kind of plant
oil, it is high in saturated fat and excessive intake may increase the blood
cholesterol level and the risk of cardiovascular diseases or stroke. Given palm
oil is low in cost, many manufacturers use palm oil for food production. It is
commonly found in ready-to-eat food or snacks e.g. instant noodles, cup noodles,
potato chips, shrimp crackers, or stuffed biscuits. We may also pay more
attention to the ingredient list on packaging when buying food to see if it is
produced with palm oil.
3. Is grape seed oil healthy?
A: Grape seed oil has a high content of unsaturated fat and antioxidant. Also, its
smoke point is higher than other types of oil, about 250℃. It is suitable for
different cooking methods, e.g. as a sauce for cold food, pan-frying, stir-frying,
deep-frying, baking etc. It is a healthy and convenient choice.
© October 2006 Department of Health
All rights reserved.
14
School ‘NutriAgent’ Handbook
4.
A:
Is rice bran oil a healthy kind of fat?
Yes. It is because rice bran oil contains a high level of unsaturated fat, which
may help reduce blood cholesterol level and the risk of cardiovascular diseases.
5.
A:
Is olive oil suitable for cooking?
The smoke point of cooking oil for frying should exceed 200℃ since cooking
oil will be oxidized and produce carcinogenic compounds if it is heated up
above its smoke point.
In general, the smoke point of extra virgin olive oil is 190℃, suitable for salad,
dip and pan-frying with small amount of oil, etc. While extra light olive oil with
smoke point of 216-238℃, is suitable for baking, stir-frying and deep frying.
6.
Is margarine healthier than butter that we can feel free to use more for
spread?
A: Using margarine instead of butter as spread will not be healthier. It is because
some margarine in market have gone through hydrogenation and thus contain
trans fat, which will also adversely affect our bad cholesterol (low density
lipoprotein cholesterol) level and increase the risk of cardiovascular diseases or
stroke. Moreover, margarine has the same level of calories as butter, which may
also lead to obesity if consumed excessively.
About Fruits and Vegetables
1.
Nowadays, a lot of vegetables in the market contain agricultural pesticides
and yet the Department of Health is suggesting people to have more
vegetables. What should we do?
A: The Centre for Food Safety of the Food and Environmental Hygiene Department
regularly takes sample of vegetables for testing of pesticide residue to ensure
that vegetables available in the market meet the standard for safe eating by
members of the public. To further decrease the intake of pesticide residue, we
can:
© October 2006 Department of Health
All rights reserved.
15
School ‘NutriAgent’ Handbook



wash vegetables well in clean running water for several times and
immerse in clear water for an hour,
boil in water for one minute and discard the water used, or
remove the outer leaves.
2.
Apart from fresh fruit and vegetables, different kinds of canned and frozen
vegetables, dried fruit and vegetables and juice can be found in the market.
How can we choose?
A: All the different kinds of fruit and vegetables above are classified in the “Fruit
and Vegetables” group. But there are better choices as follow:

Fresh fruit and vegetables require the least process, thus most of the
nutrients can be retained. Therefore, it is the best choice, frozen ones
are the second best choice.

Nutrients may be destroyed during the food process of canned fruit and
preservatives, salt or sugar are usually added in. It therefore not
recommended to have them frequently.

Dried fruit and vegetables also have gone through process, flavourings
and preservatives may be added and thus not as good as the fresh ones.

Freshly blended fruit and vegetable juice requires several manual
process steps, vitamins and fibre may be lost. Moreover, harmful
bacteria may be present if fruit and vegetable juice is handled
improperly during process or kept in room temperature for a long time.
3.
A:
Are there any fruit and vegetables should be avoided?
The following fruit and vegetables are not classified in to the “Fruit and
Vegetables” group and should be avoided because they are high in fat, sugar or
salt.

Fruit and vegetables are high in fat (e.g. coconut, durian, olive, etc.)

Deep-fried vegetable or with large amount of added fat (e.g. vegetable
tempura, fried onion rings, fried taro wedges and salad with lots of
salad dressing)

Fruit and vegetable juice with added sugar (e.g. condensed fruit juice)

Fruit desserts with added sugar (e.g. mango pudding, red bean sweet
soup, mango sago dessert with pomelo, etc.)

Preserved fruit and vegetables with lot of salt (e.g. pickled choi-sum,
pickled mustard, pickled cucumber, preserved fruit, etc.)

Canned or bottled vegetable juice
4.
What are the differences in nutritive value between different kinds of
vegetable?
© October 2006 Department of Health
All rights reserved.
16
School ‘NutriAgent’ Handbook
A:
Different edible parts of vegetable have different nutritive value:
- Leafy vegetables are rich in carotene, vitamin C, folate, calcium and
dietary fibre
- Fruits, squashes and gourds are rich in carotene, vitamin C and water
- Beans and legumes are rich in protein, carbohydrate, B vitamins, calcium
and dietary fibre
- Mushrooms and seaweeds are rich in protein, B vitamins, minerals and
dietary fibre.
To promote having good variety of food, we should choose different kinds of
vegetables.
5.
A:
What should we pay attention to when buying fruit and vegetables?
When buying fruit and vegetables, please pay attention to the following:
- Buy fruit and vegetables form shops with license and hygienic
environment
- Do not buy damaged or spoiled fruit and vegetables
- Avoid to buy cut fruit. If so, please pay attention to food safety and
ensure cut fruit has been stored at 4℃ or below
- Try to avoid fruit juice which has not been pasteurized and handled
properly (e.g. freshly made fruit juice by hawkers)
6.
A:
How to process fruit and vegetables to ensure good food hygiene?
When buying fruit and vegetables, please pay attention to the following:
- After buying fruit and vegetables, store them in refrigerator as soon as
possible
- After buying frozen fruit and vegetables, they should be stored in sealed
container and refrigerator at 0℃ or below. Defrost is not required prior
to cooking. We can wash them with water and cooked in boiling water or
steamed till done.
- Cut or peeled fruit and vegetables should be wrapped properly and stored
in the upper compartment of the refrigerator and separated from meat to
avoid cross contamination. They should be consumed as soon as
possible.
- Discard cut or peeled fruit and vegetable if stored in ambient
environment for more than 2 hours.
- Wash our hands with soup and water thoroughly prior to handling fruit,
vegetables and other foods.
- Wash fruit and vegetables thoroughly with clear water despite it is
peeled.
© October 2006 Department of Health
All rights reserved.
17
School ‘NutriAgent’ Handbook
-
7.
A:
8.
A:
Use different cutting board and utensils to handle fruit and vegetables
(ready-to-eat food) and meat (non-ready-to-eat).
Many people say that nutrients will be lost in the course of high-heat
cooking and immersing vegetables. Is that true?
Yes. Excessive immersing and washing or over-cooking of vegetables may
cause nutrient loss. The followings are some easy tips to keep the nutrients in
fruit and vegetables:
- Wash vegetables with clean water first and then immerse them into water
for about 60 minutes to remove pesticide residue. Detergent exclusively
for vegetable may also be used to shorten the immersing time.
- Avoid cutting fruit and vegetables prior to immersing
- Avoid cutting fruit and vegetables into tiny size
- Avoid over-cooking of vegetables, we may steam or blanch vegetables in
60℃ water prior to cooking by other methods.
- Avoid to cook fruit and vegetables in excessive amount of water. Add
them into boiling water only to avoid heating them up in cool water
slowly.
- When make soup, cook meat first and add vegetables at last.
How much vegetable should children have in the other two regular meals if
they cannot have them in breakfast?
Children should have two servings of vegetables or more every day and one
serving of vegetables means one bowl of uncooked vegetables or half bowl of
cooked vegetables. So, if children cannot have vegetables in breakfast, then they
should eat the sufficient quantity evenly from lunch, dinner or mid-meals.
About Lunch
1.
A:
Many lunch suppliers claim that green leafy vegetables are difficult to
process and would easily become yellow after cooking, so they are not
appealing to children. What should we do?
If the colour of green leafy vegetables is hard to keep, lunch suppliers may
consider other vegetables, such as cabbage, zucchini, Chinese mushroom, straw
mushroom, tomato, or Chinese cabbage, etc.
© October 2006 Department of Health
All rights reserved.
18
School ‘NutriAgent’ Handbook
2.
A:
Even if healthy options are available, children still like choosing the
unhealthy ones. How can lunch suppliers help them choose a healthy lunch?
Lunch suppliers should avoid supplying unhealthy options. Meanwhile, they can
highlight the healthy options to facilitate parents’ education to children about
choosing a healthy lunch box. Suppliers may also use “Today’s Special” in
menu or bonus point reward scheme to encourage children to opt for the healthy
lunch boxes.
3.
A:
How many calories should be provided in a children’s lunch?
A lunch should provide one-third of the nutrients and calories children need
daily, approximately 600-650 kcal.
4.
Can the food quantity in lunch for junior primary students be same as for
senior primary students?
As the daily nutritional needs of junior primary students are different from
senior primary students, the formers need less grains and cereals and meat.
However, there is no major difference in the need of fruit and vegetables. For
details of recommended serving quantity, please refer to the Nutritional
Guidelines on Lunch for Primary Students.
A:
5.
A:
6.
A:
What is the calories or nutrients intake ratio between breakfast, lunch, and
dinner?
The three meals should each provide one-third of the calories or nutrients needed
for a day.
The food provided by the current school lunch supplier is not quite healthy,
while parents do not have time to prepare lunch for their children. What
could be done?
Parents may refer to the Nutritional Guidelines on Lunch for Primary Students
produced by the Department of Health and reflect the problem of nutritional
imbalance in school lunch to the schools’ dedicated working group for catering
service to children, and advise the working group to send a delegate to request
the supplier to improve the nutritional quality of school lunch.
7.
Since meat is rich in protein, is that eating less rice and more from the
dishes can take in more nutrients so that children grow faster?
A: No. Cereals and grains (i.e. rice, noodles and bread) are rich in carbohydrate and
vitamins, they should be the most eaten to provide energy for daily activities and
body’s functioning. While meat is rich in protein, but its fat and cholesterol
© October 2006 Department of Health
All rights reserved.
19
School ‘NutriAgent’ Handbook
contents are higher than grains and cereals (except fried rice and fried noodles),
excessive intake not only may promote weight gain, but also harm heart health.
The ratio of grains and cereals, vegetable and meat of healthy lunch / dinner is
3:2:1 by volume.
8.
A:
It is recommended in the Nutritional Guidelines on Lunch for Primary
Students that school children should eat most grains and cereals and least
meat. Would this hamper children’s growth and development?
In fact, adults and children do not need a large intake of protein daily. Small
amount of meat, eggs or beans and legumes everyday can provide the protein we
need to maintain our normal functioning and growth of our body. Children aged
6-12 year-old are recommended to have 3-5 taels of meat or its substitutes every
day (1 tael meat = the size of 1 table tennis ball). Therefore, it is almost half of
the daily need of meat for them if a lunch provides 2 taels of meat.
About Snacks
1.
A:
Why do children have snacks?
If children can have a balanced diet for all the three main meals daily with
sufficient intake of calories and nutrients, snacks will surely not be a must. But
children with a small stomach that their nutritional needs may not be fulfilled
solely from the food from the main meals. In addition, children have high
physical activity level, they burn energy and lose water easily during learning or
doing exercise. Snacks may thus play a supplementary role. But please
remember that snacks are just supplements, they should not be consumed
excessively and could not replace the main meals.
2. How to prepare snacks for children?
A: Parents may make reference to the Nutritional Guidelines on Snacks for
Primary Students by the Department of Health to prepare “3 Lows, 1 high”
healthy snacks that feature carbohydrate. To avoid spoiling the appetite of the
next main meals, snacks should be provided in small amount and 1.5-2 hours
apart form the main meals.
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3. Children just love to choose fried and deep-fried snacks. What should we do?
A: We can first reduce children’s weekly frequency of having fried and deep-fried
snacks, replaced with fruit and vegetables. In fact, children have a good
adaptability that they will soon adapt the new taste. Therefore, parents should be
patient and provide them different kinds of fresh food, make the foods appealed
to them by the fresh taste and bright colours, healthy eating habits will then be
cultivated gradually.
4.
A:
5.
A:
6.
A:
Can we use tetra-pack drinks or sweet drinks to attract children if they do
not like water for replenishment?
Adequate water is vital to the body. It helps digest and absorb food, propel
metabolism and prevent constipation. Parents should always encourage children
to drink more water. Sweetened drinks may promote weight gain because of
their high sugar content. In general, children need about 6-8 glasses of fluid
every day with water as the major drinks, low-fat milk, low sugar soymilk, fresh
or pure fruit juice, clear soup, etc. are good choices as well.
Is it true that children should skip breakfast to avoid over-eating if they
have snacks during recess?
No. After sleeping for the whole night, the food eaten last nigh has been
digested and our blood sugar level is lower when wake up in the morning.
Having breakfast, not only avoid over-eating at recess or lunch due to furious
hunger, but also boost children’s’ thinking and learning. As for the beginning of
a day, breakfast should feature grains and cereals (e.g. bread, rice congee or oat
porridge) to provide sufficient energy.
The probiotic drinks in the market are believed to be healthy. Are they
good to children?
Although some research studies have demonstrated the probiotic promote bowl
health and help reduce the risk of some disease featured diarrhoea. However,
the probiotic drinks in the market in general are added with sugar,
over-consumption may cause excessive intake of sugar and energy, it thus
classified as “Snacks to Choose in Moderation”.
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7.
A:
8.
A:
Can sports drinks (or electrolyte-charging drinks) be used for water for
children?
Sports drinks or electrolyte-charging drinks are specially designed for person
who participants in prolonged sport activities (e.g. a 1.5 hour football match).
Compare with water, these drinks contain sugar, some may even contain
caffeine. Therefore, the best drink for children to replenish water loss during
learning and doing exercise is water.
Are food products with nutrition claims, e.g. low-fat, sugar free, fat free etc.
healthier options?
The purpose of food products with nutrition claim is for consumer to identify
healthier option easier. You may see the cholesterol free potato chip, fat free
wine gums, etc. before. Despite the potato chips are cholesterol fee, they are still
high in fat. Despite the wine gums are fat free, they are high in sugar. They are
not good to our health if having a lot.
When we shop for food, we should not only rely on the nutrition claims, we
should consider its nutritive value entirely.
About Diet and Lifestyle
1. How to define if a child is over- or under-weight?
A: To assess a child whether he/she is over- or under-weight, we should first
measure his/her height and weight, and find out its meeting point using the
“Weight-for-Height Chart” on page 25 and 26 in this chapter. If the meeting
point is
- in the shadow area (81-119% of the weight-height median), represents
normal weight
- below the shadow area (80% or below of the weight-height median),
represents underweight
- above the shadow area (120% or above of the weight-height median),
represents overweight.
In both cases of overweight and underweight, or if a child’s height-weight ratio
changes sharply within a short period of time, professional advice from physicians or
dietitians should be sought.
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2. My child has an imbalanced diet. What should I do?
A: Firstly, parents have to concede that there would be a couple of types of food
children would normally dislike. Serious nutritional problem will not be
provoked given they are not rejecting a whole food group. It is because foods
from the same group provide similar nutrients. For example, if a child does not
like capsicum, parents can replace with leafy vegetables other vegetables.
When cultivate children to have a good variety of food, parents should not force
them to eat their disliked food, as it will worsen children’s resistance to that
food. On the other hands, parents should continuously encourage their children
to try their disliked food, add other colourful ingredients or food they like to
make it more appeal. Just put in a tiny bit for the child to try at first. If the child
is fine with that, increase the amount gradually.
3.
A:
My child is on the thin side. No matter what he is given to eat, he still does
not gain any weight. What should I do?
We should first use the Weight for Height chart to assess our children’s body
weight. If children are underweight, there are many underlying reasons, e.g.
genetic factors or acquired poor dietary habits. However, parents may first
observe the everyday dietary habits of their children, such as:
- Are main meals nutritious (each main meal includes at least 3 food
groups)?
- Are children having too much unhealthy snacks?
- Are the snack times too close to the main meals?
All these inappropriate dietary habits hamper children’s absorption of nutrients.
Parents could help their children develop regular dietary pattern, prepare more
healthy and nutritious meals or snacks for them. Besides, having more exercises
promotes their body development and nutrient absorption. If there is still no
substantial improvement, professional advice from physicians or dietitians
should be sought.
4.
Children just love sugary food. Can we replace sugar with artificial
sweetener?
A: Artificial sweeteners generally refer to the “low-calorie” sweet-tasting
compounds that can replace “sugar” to augment the sweetness in food, and they
were thus named. However, the taste of sweeteners can be far sweeter than
generic “sugar”. If they were used in children’s diet, the children would become
more addicted to sweetness. This would in turn make them take in excess sugar
from other food. Therefore, children are usually encouraged to gradually change
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their current eating habits and accept food that tastes more plainly or less
sweetly.
5.
My child shows a trend of being overweight, but he does not have an
imbalanced diet. However he will be hungry if giving him too little. What
should I do?
A: Parents do not need to be too nervous and worry when their children show a
trend of being overweight. There is no need to help children lose weight with
those popular fad diets or slimming methods. We just have to encourage our
children to do sufficient amount of exercise and have a balanced diet, they will
gradually return to the healthy weight range when they grow taller.
To make children to have a healthy and balanced diet, parents may make
reference to the Nutritional Guidelines on Lunch for Primary Students and the
Nutritional Guidelines on Snacks for Primary School Students by the Department
of Health, take the “3 lows, 1 high” (low-salt, low-sugar, low-fat, and high-fibre)
as principle. The proposed servings also fit for other main meals (e.g. breakfast
and dinner). Please remember physical and mental development would very
likely be affected if over-dieting or losing weight by inappropriate methods
during the developmental stage of children.
6. Although oil is seldom used in cooking, why my child is still overweight?
A: Apart from fat and oil, excessive intake of any kind of food will also cause over
intake of calories, which may be stored as fat in our body. To help children grow
healthily and have a standard body weight, parents can make reference to the
Food Guide Pyramid of the Department of Health and pay attention to the daily
food intake of children. Parents should also encourage children to do sufficient
amount of exercise since the lifestyle of “sit more, move less” reduces calorie
expenditure and results in calorie surplus.
7. My child wants night snacks. What should I do?
A: Parents should understand their children’s need and the reason of night snacks.
Would it be insufficient eating in the day? Or is it just a bad habit? If children
are hungry that they could not fall asleep, parents may give them small amount
of food, e.g. soda crackers, bread, or low fat milk, etc. Having a large amount of
food should be strictly avoided. If having night snacks is simply a bad habit,
parents should teach them properly to help them cultivate healthy eating habits.
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1.4 How to read nutrition labeling
Since various food groups are available on the market, we should learn how to read
the labels on the packages to achieve a healthy and balanced diet. Today, many food
manufacturers have listed the nutritional contents of food on the package so that we
can be better informed of its nutritional value, compare it with other food items of the
same group and select the healthier ones for schoolchildren. In addition, nutrition
facts on the label can help people who are on special diets (e.g. people have diabetes
or heart disease) choose the right food and thus help control their conditions.
1.4.1 What is a nutrition labelling?
Nutrition labelling usually shows the nutrient content of food in tables to provide the
public with nutrition information about the food.
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1.4.2 Steps to read nutrition labelling:
1) Serving Size
According to the information shown on this nutrition label, the pack of food can be
divided into 4 servings, each equating to around 1 packet, which is about 200g.
2) Calories in the food
Each serving size provides about 320Kcal of energy, of which 15Kcal is from fat in
the food.
3) Nutrients in the food
Besides, each serving provides 69g of carbohydrate, 2g of dietary fibre, and 6g of
protein. However, people do not necessarily take the same serving as described by the
nutrition label. For example, if you consume 250g of the food, i.e. 1.25 servings, you
actually take in 1.25 times of what is listed on the label.
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1.4.3 How to make healthier food choices using nutrition labelling?
Energy and nutrient content are usually shown by “per serving”, “per 100 g” for solid
food, or “per 100 ml” for liquid food. “Serving size” may use “cup”, “spoon”, or a
fraction of the food in total (e.g. 1/2, 1/3) as the labelling unit to inform consumers of
their actual intake of energy and nutrients after consuming the food. Labelling in
terms of “per 100 g” or “per 100 ml” may help consumers compare the nutritional
value of different food items directly and make healthier and more appropriate
choices. Take the following nutrition labels of two brands of milk as example:
Milk A
Milk B
Through comparing the “per 100 ml” labelling on these two brands of milk, Milk A is
found healthier as it contains more protein, calcium and dietary fibre with less energy
and fat. Consumers may compare the nutritional value of various food items in this
way to find out the ones that better meet their needs.
1.4.4 Nutrient content claims
Nutrient content claims, such as ‘high calcium’, ‘low fat’, ‘sugar free’, or ‘low
calorie’, are usually shown on food packages to illustrate the content of nutrients in
the food. Nutrient content claims adopted by the Codex Alimentarius Commission
(Codex) are as follows:
Component
Claim
Conditions not more than
Energy
Low
40 kcal (170 kJ) per 100 g (solids); or
20 kcal (80 kJ) per 100 ml (liquids)
Free
4 kcal per 100 ml (liquids)
Low
3 g per 100 g (solids); or
1.5 g per 100 ml (liquids)
Free
0.5 g per 100 g (solids) or 100 ml (liquids)
Fat
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Saturated fat
Low *
1.5 g per 100 g (solids)
0.75 g per 100 ml (liquids)
In addition, energy from saturated fat should not exceed
10% of total energy
Cholesterol
Free
0.1 g per 100 g (solids) or 100 ml (liquids)
Low *
0.02 g per 100 g (solids)
0.01 g per 100 ml (liquids)
Free
0.005 g per 100 g (solids) or 100 ml (liquids)
For foods claimed to be “low in cholesterol“ and
“cholesterol free”, its saturated fat content should not
exceed:
1.5 g per 100 g (solids)
0.75 g per 100 ml (liquids)
In addition, energy from saturated fat should not exceed
10% of total energy
Sugars
Free
0.5 g per 100 g (solids) or 100 ml (liquids)
Sodium
Low
0.12 g per 100 g
Very
low
0.04 g per 100 g
Free
0.005 g per 100 g
* In the case of the claim “low in saturated fat”, trans fatty acids should be taken into
account where applicable. This provision consequentially applies to foods claimed to be
“low in cholesterol“ and “cholesterol free”.
Materials in this chapter are mainly from the Health, Welfare and Food Bureau and
the Food and Environmental Hygiene Department.
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2. Tools for monitoring the eating environment at school
Undoubtedly, provision of more healthy food choice can definitely promote healthy
eating to students. To facilitating schools selecting appropriate school lunch supplier
that can provide healthy and tasty lunch, beneficial to the promotion of healthy eating
at school, the Department of Health has developed a ‘Database on School Lunch
Suppliers’ and ‘Selecting the Right School Lunch Supplier’ proposed procedure and
points to be noted in selecting school lunch supplier. Furthermore, a selection
checklist has also been drafted for schools’ and parents’ reference. The ultimate goal
is to keep the mechanism fair, open and transparent. The above mentioned materials
have been uploaded onto the thematic website: http://www.eatsmart.gov.hk.
Selecting right school lunch supplier is obviously a crucial step making students eat
healthier. However, there is still a long way to go. We may need to regularly monitor
the provision of school lunch and find ways to motivate and reinforce students’
healthier choose. To help schoolchildren develop good eating habits at school, we
encourage lunch suppliers, tuck shop operators, parents, and school personnel to
cultivate an environment conducive to healthy eating at school through close
cooperation. It is suggested that the representatives of schools and parents’
associations use the surveillance forms in this chapter to monitor the nutritional
quality of lunch and snack and the pace of healthy eating promotion at school.
2.1 Surveillance tool for school lunch –Nutritional Quality Evaluation Form of
School Lunch
Lunch quality will be monitored every month. The school may appoint two teachers
or parents to take this responsibility. Lunch quality should be evaluated in five
consecutive days of one week each month selected by the person in charge. Materials
required are:

Categorization of Lunch Food Item (Page 33 of this section);

Nutritional Quality Evaluation Form of School Lunch (Page 34 of this section);
and

Lunches of the week
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