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Nutritional and Exercise Guidelines
For Healthy Children

 

 

Studies suggest that the typical diet of American families may be linked to a variety of health problems, including obesity, diabetes, high blood pressure, elevated cholesterol levels, and atherosclerosis (the buildup of cholesterol, fatty deposits, and other substances in the lining of the arteries of the heart). Obese children are at increased risk for many health problems. Successfully preventing or treating childhood obesity may reduce the risks of adult obesity, heart disease and other medical problems.

The development of healthy eating and exercise habits during childhood may reduce the incidence of obesity and related problems during adulthood. Parents and guardians can help children learn about and develop healthy lifestyles.

Despite our nation’s preoccupation with slenderness and physical fitness, our children are growing heavier and more sedentary.  According to the most recent National Health and Nutrition Examination Survey conducted by the Centers for Disease Control and Prevention, more than 25% of American children ages 6-17 are overweight.  It is known that overweight children are likely to suffer from problems ranging from low self-esteem to serious chronic health conditions later in life.  

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HEART-SMART DIETARY GUIDELINES

The American Heart Association recommends the following dietary guidelines for all healthy children and adolescents over 2 years of age. This eating plan supports a child’s normal growth and development. It provides enough total energy and meets or exceeds the recommended daily allowances of all nutrients required by children and adolescents.

Adequate nutrition should be achieved by eating a wide variety of foods from the following food groups:

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  • Vegetables and fruits, fruit juices and vegetable juices - 4 or more servings
  • Breads, cereals and starchy foods - 4 or more servings
  • Milk and cheese - 3 or more servings
  • Meat, poultry, seafood, dried beans and peas, eggs - no more than 2 servings daily
  • Unsaturated fats and oils - 4 to 6 servings
  • Other foods to meet energy needs - low fat, low cholesterol foods or increase portions of above foods                                                                                    Return to top

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Energy (calories) should be adequate to support growth and development and to reach or maintain desirable body weight. Caloric intake should be sufficient to provide energy for every day activities and to reach or maintain a recommended body weight.

·         Limit fat intake by choosing foods that are low in fat and rich in carbohydrates, such as cereals, grains, fruits, and vegetables.

·         The following pattern of nutrient intake is recommended:

Saturated fat - less than 10 percent of total calories

Total fat - an average of no more than 30 percent of total calories

Dietary cholesterol - less than 300 milligrams per day

 

American Heart Association Dietary Guidelines for Children                      Return to top

Developmental issues that guide rational approaches to feeding children   

  • Physical maturing continues, increased appetite and awareness of peers
  • More muscle and bone development as well as adult dentition
  • Kids may eat many meals away from home, eat fast food
  • New independence in food selection and snack choices
  •  Becoming more aware of health and risks to good health
  • Big connection between TV viewing and obesity!
  • Kids who watch TV are less active, exposed to many food ads—most ads promote nutritionally poor choices  
  • Family dynamics can affect eating habits
    Parents--be a good role model, eating-wise.  Children imitate what they see.

 

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DIETARY REMINDERS AND SUGGESTIONS

·        Fruits, vegetables, and grain products are generally lower in fat and contain no cholesterol

·        Choose lean meats, skinless poultry, fish and low-fat or nonfat dairy products

·        Processed foods (example: “Lunchables”â) can be high in fat, cholesterol, and sodium.

·        Snacking is a natural part of a child’s eating pattern. Snacks can provide a way to get essential nutrients and calories not eaten at meal times. Healthy snacking should include fresh fruits, vegetables, unbuttered popcorn, rice cakes, low-fat cheeses, dried fruits, low-fat and nonfat or frozen yogurt. Candy, cookies, cakes etc. and “gummy fruit ” treats should be limited.

·        The appetites of children change frequently. Diet and meal planning should be flexible and nutritious without being too rigid.                                                         Return to top

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 OBESITY AND OVERWEIGHT CHILDREN

The primary goal of individual treatment of obese children should be the prevention of weight gain above what is appropriate for expected increases in height. For many children this may mean limited or no weight gain while height growth proceeds normally. Recommendations for maintaining the weight of an obese child include:

  • Reducing dietary fat and careful attention to diet to avoid excessive caloric intake
  • Regular physical activity/exercise.
  • Parents’ involvement in modifying the child’s behavior and modeling of healthful eating and activity habits. 
    American Heart Recommendation                                                  Return to top

Nutritional Tips for Living in the Real world

Breakfast offerings

  • Milkshakes with fruit and milk
  • Low-fat yogurt with dry cereal, peanut butter on crackers, apple with milk
  • Granola bar with milk
  • Leftover pizza, or spaghetti, or a sandwich

Lunch Issues

Strategies for brown-baggers

  • Sit down and plan lunches together
  • Send age-appropriate portions of food
  • Send favorite foods
  • Make lunch fun—decorate bags
  • Pack a nutritional beverage
  • Yogurt, fruit cups, cereal boxes
  • Pack a re-freezable ice pack, frozen juice box or use insulated bags and bottles

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Strategies for lunch buyers

  • Allow child to order own meals
  • Post school lunch menus on fridge
  • Supplement meals on certain days with healthy snacks
  • Let kids buy chocolate milk                    

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Quick, healthy and smart snack ideas

  • Snacks should offer nutrient value, calories, be accessible, easy   for child to prepare
  • Do not offer snacks in front of the TV
  • Offer snacks 1 1/2-2 hours before meals
  • Occasional meal skipping and finicky food habits are normal
  • Offer disliked items TEN times before giving up!
  • Serve cut up fresh fruit on everyone’s plate before dessert 
  • When eating fast food out, say no mayo, hold the cheese, and ask if they have whole grain buns, order salad vs. coleslaw
  • Work towards a relaxed, happy atmosphere @ mealtime
  • Offer praise for making good food choices

 

EXERCISE (PHYSICAL ACTIVITY) AND CHILDREN

The American Heart Association recommends a combination of daily moderate and vigorous physical activity for both children and adults. Physical activity is important because of it’s overall physical, psychological and social benefits. Inactive children are likely to become inactive adults.  Physical activity helps with:

  • Weight control

·         Reducing blood pressure

·         Raising HDL ("good") cholesterol

·         Reducing the risk of diabetes and some kinds of cancer

 

The American Heart Association recommends that...

·         All children age 5 and older should participate in at least 30 minutes of enjoyable, moderate-intensity activities every day.

·         All children participate in vigorous physical activity that promotes heart and lung fitness 3 or more days per week for at least 30 minutes per occasion.

·         If your child or children do not have a full 30-minute activity break each day, try to provide at least two 15-minute periods or three 10-minute periods in which they can engage in various activities appropriate to their age, gender and stage of physical and emotional development.

·         Increase physical activity levels of youth by reducing the amount of time they participate in sedentary behaviors such as watching TV or playing video games.   

For more advice on ways to get kids to eat healthy....resources and recipes, go to our Health Service's Kids, Food, Fun and Fitness Page

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Some Nutrition Links

American Heart Association on diet and exercise
American Dietetic Association
Diet & Nutrition
Dole's 5 a Day Website
Food and Nutrition Information Center
Tufts University's Nutrition Navigator
USDA Center for Nutrition  

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Recommended books for parents

American Academy of Pediatrics Guide to Your Child’s Nutrition:  Feeding Children of All Ages by Lorraine Stern (Editor) and William H. Dietz (editor), AAP (1999)

Child of Mine:  Feeding with Love and Good Sense by Ellyn Satter (1991)

Healthy Snacks for Kids (Nitty Gritty Cookbooks) by Penny Warner (1996)

How to Get Your Kid to Eat, But Not Too Much by Ellyn Satter (1987)

Meals Without Squeals:  Childcare Feeding Guide and Cookbook by Chrisitne Berman, Jacki Fromer, Ellyn Satter (1997)

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Recommended books for kids

Blubber by Judy Blume (1983) ages 10-14

Bread and Jam for Frances by Russell Hoban (1993) ages 3-6

D.W., The Picky Eater by Marc Brown (1995) ages 3-6

The Cat Ate My Gym Suit by Paula Danziger (1988) ages 9-13

Good Enough to Eat: A Kid’s Guide to Food and Nutrition by Lizzie Rockwell  (1999) ages 4-8

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Information on this page contributed by Maryalice Stamer, RNC, PNP
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