Download in the Guidelines?

Questions and Answers:
Food and Nutrition Guidelines for Healthy Children and Young
People (Aged 2–18 years): A background paper
1. Why have the Guidelines been updated?
The Ministry has previously published two papers – Food and Nutrition Guidelines for Healthy
Children (Aged 2–12 years): A background paper (1997) and Food and Nutrition Guidelines for
Healthy Adolescents: A background paper (1998) (“background papers”). This new paper is an
amalgamation of those.
Furthermore it updates the previous two papers to provide current, evidence-based recommendations
and technical information to support optimal nutrition in children and young people aged 2–18 years of
age.
2. What are the benefits of improved nutrition and physical activity levels in children and
young people?
Good nutrition and physical activity during childhood and adolescence are essential for good health
as well as normal growth and development.
Two to 18 year olds represent a quarter (just over a million people) of our total population, and their
dietary requirements are different to those of adults. Their requirements also change over time as
children and young people grow.
Establishing good nutrition and physical activity patterns and behaviours in childhood and
adolescence also contributes to good health in adulthood. Evidence1 has shown that health status
during childhood and adolescence impacts on health, and the health system, during adulthood.
3. Who is the background paper for?
Health practitioners – including dietitians, nutritionists, doctors, nurses, primary health care providers,
health promoters, and others working with children and young people in clinical and population health
settings. The background paper guides and supports health practitioners in the practice of healthy
nutrition and provides them with a detailed information resource.
In addition, the background paper provides current evidence-based technical information for
educators and those teaching students about optimum nutrition in children and young people.
The background paper will also be available on the Ministry website for individuals who are
particularly interested in the evidence base for the Ministry’s nutrition policy for children and young
people.
4. What are the differences between the 1997/1998 and the 2012 papers?
A number of sections from the two previous background papers (1997 and 1998) have been revised
and strengthened and new sections have been included.
Revised and strengthened sections are on: nutrients; growth and body size; fluids including alcohol;
supplementation; vegetarian eating; body image and dieting; physical activity; eating behaviour in
children; and allergies.
New sections in this background paper include: considerations for Māori, Pacific people and Asian
population groups; the meal patterns of New Zealand children and young people; oral health; picky
1
Baker JL, Olsen LW, Sorensen TIA. 2007. Childhood body-mass index and the risk of coronary heart disease in
adulthood. New England Journal of Medicine 357 (23): 2329-2337.
eating in children; food additives; caffeine; and the influence of the home environment and the wider
environment on what children, young people and their families eat.
Key new or updated information in the 2012 background paper include:
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The New Zealand-World Health Organization Growth Charts (0-5 years) (Ministry of Health
2010).
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An update of the nutrient section to reflect the 2006 Nutrient Reference Values for Australia
and New Zealand. Nutrients which may either be over or under consumed by New Zealand
children and young people are identified with recommendations for practical interventions.
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The inclusion of national data specific to children and young people aged 5–18 years on meal
patterns; nutrient intakes and status; and physical activity patterns.
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Physical activity recommendations for children and young people, as well as approaches to
reduce sedentary behaviour.
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Topical issues related to 2-18 year olds including (i) energy drinks and energy shots, (ii)
intense (artificial) sweeteners and (iii) body image and disordered eating.
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Influences on the diet of children and young people and practical suggestions to assist
parents and caregivers to encourage healthy eating in the home.
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The causes and impacts of overweight and obesity on children and young people with links
made to the Ministry’s Clinical Guidelines for Weight Management in New Zealand Children
and Young People (December 2009).
5. What consultation was undertaken for these new guidelines?
Prior to work beginning on the revised background paper in 2009 a number of key stakeholder groups
were asked to provide feedback on the proposed structure and content.
The Ministry published a draft for consultation in November 2010 with a six week submission period.
Forty four submissions were received from a range of health and nutrition practitioners, nongovernment organisations, academics, the food industry; professional associations and individuals
with an interest in the health of children and young people.
An independent analysis of the 44 submissions showed overall there was general support for the draft
for consultation. Technical comment was provided in several submissions. Submissions from the food
industry tended to focus on specific food groups of interest to them, and the role of manufactured
foods in the diet.
As a result of consultation, further specialist advice was sought on some topics. For example, the
sample meal plans were reviewed by dietitians to ensure ethnic diversity. In addition, parts of the
nutrient section were strengthened and more discussion on the dietary habits and eating patterns of
young people was included.
6. What are the key messages for healthy children and young people?
The New Zealand Food and Nutrition Guideline Statements for healthy children and young people are
the key recommendations to ensure optimal growth and prevent nutritional deficiencies, obesity and
diet-related chronic diseases.
The guideline statements are as follows:
1. Eat a variety of foods from each of the four major food groups each day:
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vegetables and fruit, including different colours and textures
breads and cereals, increasing wholegrain products as children increase in age
milk and milk products or suitable alternatives, preferably reduced or low-fat options
lean meat, poultry, fish, shellfish, eggs, legumes, nuts and seeds*.
2. Eat enough for activity, growth and to maintain a healthy body size.
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Eat regularly over the day, that is, have breakfast, lunch and dinner, and include in-between
snacks for young children or if hungry.
3. Prepare foods or choose pre-prepared foods, snacks and drinks that are:
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low in fat, especially saturated fat
low in sugar, especially added sugar
low in salt (if using salt, use iodised salt).
4. Drink plenty of water during the day. Include reduced or low-fat milk every day.
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Limit drinks such as fruit juice, cordial, fruit drink, fizzy drinks (including diet drinks), sports
drinks and sports water.
Energy drinks or energy shots are not recommended for children or young people.
Do not give children less than 13 years of age coffee or tea. If young people (13 years and
older) choose to drink coffee or tea, limit to one to two cups per day.
5. Alcohol is not recommended for children or young people.
6. Eat meals with family or whānau as often as possible.
7. Encourage children and young people to be involved in shopping, growing and cooking family
meals.
8. Purchase, prepare, cook and store food in ways to ensure food safety.
9. Be physically active.
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Take part in regular physical activity, aiming for 60 minutes or more of moderate to
vigorous activity each day.
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Spend less than two hours a day (out of school time) in front of television, computers
and gaming consoles.
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Be active in as many ways as possible, for example, through play, cultural activities,
dance, sport and recreation, jobs and going from place to place.
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Be active with friends and whānau, at home, school, and in your community.
*Do not give small, hard foods such as whole nuts and large seeds until children are at least 5 years old to reduce risk of
choking.
7. How can I provide key information from the background paper to my clients in a user
friendly form?
The Ministry produces health education resources for the public that are based on information from
the Food and Nutrition Guidelines. The recently updated resources focused on nutrition for children
and young people (Aged 2-18 years) are:
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Eating Well for Healthy Children aged 2-12 years (HE1302)
Healthy Eating for young people aged 13- 18 years (HE1230)
The Ministry’s resources focused on physical activity for children and young people (Aged 2-18 years)
are:
 Be Active Every Day: Physical Activity for 5 to 18 year olds (HE2312)
 Be Active Every Day – A3 poster (HE2313)
These resources can be downloaded or ordered on www.healthed.govt.nz or in hard copy from your
local Public Health Unit (regional addresses can be found on the healthed website)
8. Why is there a recommendation to limit time in front of television, computers and gaming
consoles (ie screen time) in the Guidelines?
Screen time is a sedentary behavior that is relatively easy to measure. Sedentary behaviour is
considered activity that does not increase energy expenditure substantially above the resting level eg
sleeping, sitting, watching television. There is evidence that being sedentary, regardless of the time
spent being physically active, is a risk factor for health problems like obesity, cardiovascular disease
and diabetes.
9. Why have the recommended intakes of some nutrients changed?
The revised background paper uses the 2006 Nutrient Reference Values (NRVs) for Australia and
New Zealand, which include the new recommended dietary intakes (RDIs). Previously, New Zealand
has used the 1990 Australian RDIs and these were used in the previous guidelines background
papers for healthy children (Aged 2-12 years) and healthy adolescents (young people).
The term Recommended Dietary Intake (RDI) refers to the average daily intake level of a particular
nutrient that is sufficient to meet the requirements of nearly all healthy individuals in a particular life
stage and gender group.
10. How can I get a copy of the background paper and health education resources?
You can view and download a copy of the background paper, or order a hard copy from the website:
http://www.health.govt.nz
The health education resource for the public given above can be downloaded or ordered at
www.healthed.govt.nz or in hard copy from your local Public Health Unit (regional addresses can be
found on the healthed website).