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FOOD GROUPS Bread, rice, potatoes, pasta and other starchy foods Why should they be included in the diet? Carbohydrates, the term used to describe starchy foods and sugars are an important source of energy and B vitamins. B vitamins are particularly important for the brain and nervous system and energy metabolism. Sugar can be categorised as follows: those found in milk (milk sugars); those found in other foods such as fruit and vegetables (intrinsic sugars) and non-milk extrinsic sugars like sugar and honey. Starchy foods should contribute 40% energy in children and sugar 11% or less. As milk intake declines and appetites increase it is recommended that starchy foods are encouraged as they are an important source of energy, fibre and B vitamins. Why do children need fibre? Fibre is found in cereals and vegetables and it is the part that is not broken in the small intestine; it is important for a healthy bowel; helps to prevent constipation and bowel disorders; and helps with cholesterol lowering. Constipation in children can be related to poor intake of fibre and fluid, emotional disturbances and change in routine. It may be alleviated by a moderate increase in fibre, but it is important to ensure the child is having an adequate fluid intake. Should we give our children a high fibre diet? There is little evidence for the effects of dietary fibre in young children and no recommendation regarding intake. Children that are poor eaters should not have fibre rich foods at the expense of energy dense foods; however with rising obesity, an increase in fibre rich foods may help to reduce energy rich foods. List some good sources Foods from this group should be offered at every meal and can be useful foods to offer as part of a snack; these foods should constitute a third of the daily intake. It is ideal that the main source of carbohydrates in the diet they should be starchy foods like bread, pasta, rice, potatoes, chapatti, naan, pitta, rolls, bagels, bread sticks, cous cous, oats, crackers, tortilla, quinoa, breakfast cereals, yam, sweet potato Be cautious with tinned and processed products as they can be salty. Avoid high sugar breakfast cereals. Foods and Drinks high in Fat and /or Sugar What foods fall into to this food group? These foods are high in non milk extrinsic sugars and fat. Soft drinks, squash, sweets, chocolate, cakes, biscuits, sugar, honey, butter, margarines, oils, pastries, crisps. Do we need non-milk extrinsic sugars? Children do not need NME sugar for energy; they can meet all their requirements from starchy foods, milk sugars and intrinsic sugars. Why should NME sugars be avoided? The intake of non-milk extrinsic sugars among pre-school children is currently higher than recommended providing 20% of the energy intake in children aged 1-4 years. Foods high in sugar usually provide calories but very few other nutrients. In addition the development of tooth decay is positively related to the amount and frequency of NME sugars in the diet. Do we need fat in our diet? Fat provides concentrated energy. Some of the fats in the diet are essential and important for healthy growth and development. Omega 3 fats are essential for brain development in babies and thought to be cardio-protective in adults. How much fat should there be in children’s diet? Infants derive 50% of their energy from fat and with increasing age to 5 years it is expected that this will decline to 35% of energy. Low fat diets may have an adverse impact on children’s growth and development. Alternatively children consuming higher fat diets may have lower intakes of iron and vitamin C. Saturated fats, from animal sources, should provide 11% of the total energy intake; currently the intake in 1-4 year old is 16% which is only to be expected in view of the high milk consumption. Fruit and Vegetables Why is it important to have fruit and vegetables in our diet? Fruit and vegetables are an important source of vitamins and fibre. Vitamin C has an important role in preventing disease and maintaining good health. In a national survey of children 1½ - 4½ years 38% had intakes below the RNI. Vitamin A comes in two forms, retinol, found in animal products and carotene, found in fruit and vegetables. Vitamin A is essential for a healthy immune system and for growth. Both deficiency and excessive intakes can be a problem in children. In a national survey of children 1½ 4½ years almost half had intakes below the RNI, probably as a result of a low vegetable intake. Therefore vitamin drops containing vitamin A, D and C are recommended for all children under 5 years and are available free of charge under the Healthy Start Scheme. In adults the antioxidant properties of certain vitamins (carotene and vitamin C) protect against coronary heart disease and cancer. How many portions should children consume daily? Children are advised to have 5 portions daily, ideally two from fruit and three from vegetables. Children under 5 should be encouraged to have at least 5 different tastes to encourage a greater intake as they get older. Carotene can be found in carrots, mango, apricots, green leafy vegetables, tomatoes and red peppers. What is a portion? Meal Times ½ - 1 healed tablespoon cooked vegetables 4-5 green beans 1-2 broccoli or cauliflower florets ½ tablespoon dried fruit 1-2 tablespoons stewed or canned fruit 100-150mls diluted 100% fruit juice Snacks ½ medium carrot 2-3cm piece of cucumber 1 small celery stick 4 cherry tomatoes 1 ring of pepper ½- 1 small banana, kiwi ½ apple or pear 1 plum ¼- ½ orange 1 tablespoon soft fruit 4-6 strawberries 8-10 grapes How can we incorporate more fruit and vegetables? Children under 5 should have fruit and vegetables offered as part of all their main meals and snacks provide an opportunity to try new fruit and vegetables. Fresh, frozen, dried and tinned varieties are acceptable; be cautious with some dried and tinned as they may have added sugar or salt. Fruit juice (100%) can be included as a portion of fruit, but they do contain high amount of sugar and can damage teeth so serve diluted. Experiment with different vegetables, dishes, cooked or raw to find those that are acceptable. Include salad in sandwiches; offer fruit with snacks; provide fruit based desserts; incorporate many vegetables into dishes e.g. curry Milk & Dairy Foods Why should children have dairy products in their diet? Dairy products are an important source of protein, calcium, zinc and some B vitamins. Protein is essential for growth, for the maintenance and repair of body tissue and for enzymes which control many body functions. Calcium is necessary for bones and teeth. Zinc plays a major role in the functioning of every organ. In a national survey of children 1½ - 4½ years more than 70% of children had intakes below the RNI. A third of zinc in the diet of children under 5 is supplied by milk and dairy products. Retinol is found in dairy products and provides a third of the daily vitamin A intake. Should they be careful in the amount they consume? This group of foods have a high content of animal fat, but that is less of a concern in children under 5years as they need energy and dairy products are an important source of nutrients. What are the best sources? Milk – full fat in children under 2 years and semi- skimmed milk until 5 years Cheese Yoghurt and Fromage Frais – full fat Avoid unpasteurised milk or cheese and yoghurts/fromage frais containing high quantities of sugar. Children on a dairy free diet must have suitable alternative such as calcium supplemented soya or rice milk. Goats milk is not a suitable alternative for a child with cows milk intolerance. How much should they consume? Food from this group should be offered at 2-3 meals and snacks each day. Meat, Fish, Eggs, Beans and other non-dairy sources of Protein What are the benefits of this food group? The foods in this group are an important source of protein, minerals such as iron and magnesium and some B vitamins. These nutrients are important for growth and development; structure and functioning (enzymes, hormones and immune system). Oily fish contain omega 3 fats which are essential for brain development in babies and thought to be cardio-protective in adults. B vitamins are particularly important for the brain and nervous system and energy metabolism. How much should a child be receiving? Most children in the UK have more than adequate intakes of protein. However deficiency of iron is common in children aged 1-3 years; iron is essential for haemoglobin which transports oxygen around the body. In addition, iron is known to have a longer term impact on intellectual performance and behaviour. 84% of children in Britain have intakes below the RNI for iron. The incidence of iron deficiency is known to be greater among children from ethnic groups. Risks associated with a poor iron intake Poor weaning diet Prolonged milk intake Vegetarian and vegan diets There are two source of iron o Haem iron derived from animal sources such as meat and oily fish. Heam iron is more available to the body. o Non-Haem iron found in foods of plant origin such as cereals and vegetables Tea drinking Main meals should always contain an item from this group and they can be served as part of a snack e.g. as fillings in sandwiches. Do we need to be careful about the foods selected in this food group? Avoid processed meat high in fat and salt. Fish – look out for the blue and white logo of the Marine Stewardship Council which guarantees sustainability Limit processed fish products such as fish fingers to once a week. Liver and liver pate contain very high levels of vitamin A and so must be limited to once a week. Avoid tinned products that are high in salt or sugar. Limit processed meat alternative foods to once a week. What are the best sources? Fish, all types of good quality meat, well cooked eggs, pulses, meat alternatives such as soya, quorn or tofu. Important non-haem iron sources peas, beans and lentils What should a child be drinking? Tap water is suitable for children and should always be the drink of choice for quenching thirst Milk is an important source of calcium and should be offered as a drink in a cup. Full fat milk until two years of age and semi skimmed from 2 to 5 years. Soft drinks These comprise: Squashes which need to be diluted which may contain sugars and/or sweeteners Carbonated soft drinks e.g. lemonade Fruit drinks containing fruit, water and sugars and/or sweeteners High intakes of soft drinks have been reported to lead to frequent looser stools, poor appetites and failure to thrive. Those drinks containing sugar and acidic drinks can be harmful to teeth. Sweeteners are not recommended for children. Squash can be diluted 1 part to 10 parts water. Discourage soft drinks Pure fruit juices provide vitamin C but should be offered with meals due to the risk of dental caries. Tea and coffee are not recommended. How much should a child be drinking? Approximately 1 to 1.5 litres per day between the ages of 1 and 5 years.