Objectives

 At the end of presentation the listiner will be able to:

Identify food groups .1
Understand food groups importance .2
Acknowledge micronutrients importance .3
Assess nutrition status of children .4
Assess factors affecting children food .5
Identify children who need vitamins-minerals supplements .6
 7. Enumerate problems and concerns that affect children
 8. Identify nutrient-deficiency diseases
 9. Assess eating habits of school children
 10. health teaching about good vs. bad habits
 11. Manage nutrition health problems e.g. overeating and
under-eating
 12. Make healthy meals to school aged children
 Outlines
 Introduction
 Dietary requirements
 Suggested dietary servings from every food group
 vitamin and minerals
 Nutritional assessment
 Factors Influencing Food Intake
 vitamin-Mineral Supplements
 Children who need supplements
 Cont…

 Nutrition Education
 Nutritional Concerns
 Nutrient-deficiency diseases
 Eating habits
 Bad-vs-good-eating-habits-among-children
 Family teaching
 Advice for school-aged children good nutrition
 How to manage overeating and undereating
 Introduction
Maintaining a balanced diet and regular exercise is important
for all individuals, especially school-aged children (6-12 years).
These children are required to eat a variety of foods from each
food group to ensure optimal intake of all vitamins and minerals.
At the same time, they may face new challenges regarding
food choices and habits. Decisions about what to eat are partly
determined by what is provided in school, at home,
the influences from friends at school, and the media, especially
 Cont…
Poor nutrition compromises both the quality of life
of school-aged children but also their potential to
.benefit from education
Adequate nutrition of school aged children will also
ensure they grow to their full potential, and provide
.the stepping stones to a healthy life
Attaining optimal nutrition involves eating three meals
a day and two nutritious snacks as well as limiting the intake
.of high sugar and high fat foods can also prevent many medical problems
 Dietary requirements

Because children are growing and developing bones, teeth,

muscles, and blood, they need more nutritious food in
proportion to their size than do adults. They may be
at risk for malnutrition when they have a poor appetite
for a long period, eat a limited number of foods, or dilute
their diets significantly with nutrient-poor foods. The dietary
reference intakes (DRIs) are based on current knowledge
of nutrient intakes needed for optimal health .
 Energy
The energy needs of healthy children are determined by
basal metabolism, rate of growth, and energy expenditure
.of activity Boys Girls Age
depending ,1,200-2,000 1,200-1,800, depending 5-8
on growth and activity on growth and activity
level level
depending ,1,600-2,600 1,400-2,200, depending 9-13
on growth and activity on growth and activity
level level
depending ,2,000-3,200 1,800-2,400, depending 14-18
on growth and activity on growth and activity
level level
 …Cont

from 4 to 18year-olds
suggested intake proportions of energy are 45% to 65%
as carbohydrate, 25% to 35% as fat, and
.to 30% as protein 10%

The DRIs for estimated energy requirement (EER)

are average energy requirements based on life-stage
.groupings for healthy individuals of normal weight
 Carbohydrates

Carbohydrates are the main source of energy for school-age children.

The recommended dietary allowance for carbohydrates is 130 grams of

carbohydrates for children of all ages, according to the Dietary Guidelines for
Americans. Whole Grains 6-11 servings per day. Each serving should equal one
slice of whole grain bread (beware of breads with only “wheat” versus “whole
wheat/ whole grain”, 1/2 cup of rice or 1 ounce of whole grain cereal (stay away
from the high sugar cereals).
 …Cont

Choosing carbohydrate sources such as whole grains,

milk products, fruits, vegetables and legumes more so than

refined grains and added sugars will help increase

the nutrition of your child’s diet.

 Protein

Protein is important for growth, strength and muscle maintenance in

school-age children.
 …Cont
,servings of 2-3 ounces of cooked lean meat, poultry 2-3
or fish per day. A serving in this group may also consist of
.cup of cooked dry beans, one egg 1/2
,High-protein foods include lean red meat, chicken, turkey
,seafood, eggs, dairy foods, peanut butter, soy products, legumes
.nuts and seeds
 Dairy products

2-3 servings (cups) per day of low-fat milk or yogurt,

or natural cheese (1.5 ounces=one serving).

 Fats

Healthy fats are also important to a child’s development,

especially omega-3 fatty acids, are important for your child’s cognitive
development. The American Heart Association recommends that school-age
children and teens gain 25 to 35 percent of their daily calories from

fats -- especially mono- and polyunsaturated fats

 …Cont

Sources of these healthy fats include vegetable oils, canola oil, peanut oil,

and olive oil, avocados, peanut butter, hummus, nuts (like almonds,

hazelnuts, and pecans), and seeds. Foods high in omega-3 fatty acids include ,
found in fatty fish, such as salmon, herring, mackerel, anchovies,

and sardines, purified fish oils, canola oil, walnut oil, walnuts, soybeans

, soybean oil, algal oil, flaxseeds, flaxseed oil and pumpkin seeds.
 Vegetables

3-5 servings per day. A serving might be one cup of raw leafy

vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables,

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,

such as an apple, banana or pear

 Water

School children need adequate

amount of water everyday and

need to be reminded to

drink 6-8 glasses every day

Suggested dietary servings from every
food group
 Minerals and Vitamins

Minerals and vitamins are necessary for normal

growth and development. Insufficient intake can

cause impaired growth and result in deficiency diseases

Iron
Iron is an essential nutrient and is used in making red blood cells which carry oxygen around the
body. Iron also plays an essential role in maintaining a healthy immune system.

Group age Daily Intake

4-8 10 milligrams

9-13 8 milligrams

13-18 boys 11 milligrams

13-18 girls 15 milligrams

 Calcium
Calcium is needed for adequate mineralization and maintenance
,of growing bone in children. The RDA for calcium for children is
.for children it is, and for those it is
 …Cont

Actual need depends on individual absorption rates and dietary

factors such as quantities of protein, vitamin D, and phosphorus.

Because milk and other dairy products are primary sources of calcium,

children who consume limited amounts of these foods are often

at risk for poor bone mineralization. Other calcium-fortified foods

such as soy and rice milks and fruit juices are also good sources.
 Zinc

Zinc is essential for growth, improving memory

and school performance, especially in boys. Good
sources of zinc are oysters, beef,
liver, dried beans and peas, whole grains,
fortified cereals, nuts, milk, cocoa, and poultry.
Deficiency results in growth failure, poor appetite,
decreased taste acuity, and poor wound healing.
Cont..
Because the best sources of zinc are
meat and seafood, some children may regularly
have low intake. Diagnosis of deficiency , especially
marginal deficiency, may be difficult because laboratory
parameters, including plasma, serum erythrocyte, hair , and
urine, are of limited value in determining
zinc deficiency . There is a positive influence
of zinc supplementation on growth and concentrations.
Vitamin D is needed for calcium absorption
and deposition of calcium in the bones;
other functions within the body, including prevention
of chronic diseases such as cancer, cardiovascular
disease, diabetes are important areas of investigations.
Because this nutrient also is formed from
sunlight exposure , the amount required depends on
geographic location and time spent outside.
Cont..
The DRI for vitamin D for infants
is 400IU (10mcg) per day and for
children is 600IU (15mcg) per day. Vitamin
D-fortified milk is the primary dietary source
of this nutrient, and breakfast cereals and
nondairy milks often are fortified with vitamin D.
Dairy products such as cheese and yogurt,
Cont..
however, are not always made from fortified
milk. Milks other than cow milk (e.g.,
goat, soy, almond, or rice) may not
be fortified with vitamin D. For young
children the current DRI for vitamin D
is higher than what may be consumed
from a typical diet.
 Nutritional Status Assessment

Nutritional status is an important indicator enabling

diagnosis nutritional status is assessed using anthropometric
measurements, biochemical, clinical and dietary data
determining whether child well nourished or mal-nourished .
 Anthropometry:
Height, weight, head circumference and mid upper
arm circumference.
Cont…
Converting measurements into index:
Weight for age is an index used
in growth monitoring for assessing children who
may be underweight .Height for age is
an index used for assessing stunting (chronic malnutrition).
Weight for height is an index for
assessing wasting (acute malnutrition).
Cont…
 Biochemical (lab data) e.g., electrolytes, glucose,
Tests such gastric emptying time and resting
metabolic rate.
 Clinical methods involve checking signs of deficiency or
asking the patient about symptoms that
suggest nutrient deficiency, these signs include pallor,
pitot's spots on the eyes, pitting edema,
goiter and severe visible wasting.
Cont…
 Dietary methods include looking at past and
current intakes of nutrients from food by
child to determine their nutritional status.
 Vitamin-Mineral supplements

Families with more education, health insurance

coverage, and higher incomes generally have higher
rates of supplement use , although these may
not be the families who are at greatest
risk for having inadequate diets.
The AAP does not support
giving healthy children routine supplements of any
vitamins or minerals other than fluoride.
Cont…
However, children at risk for inadequate nutrition
who may benefit include those:
 with anorexia, inadequate appetite, or who consume fad diets.
 with chronic disease (e.g., cystic fibrosis, inflammatory bowel
disease, hepatic disease).
 from food-deprived families or who suffer
parental neglect or abuse.
Cont…
 who participate in a dietary program for managing
obesity.
 who consume a vegetarian diet without adequate dairy
products.
 with faltering growth (failure to thrive).
 with developmental disabilities.
Children who routinely take a multiple vitamin or
Cont…
a vitamin-mineral supplement usually don’t experience negative
effects if the supplement contains nutrients in
amounts that don’t exceed the DRIs. Children
should not take mega doses, particularly of the
fat-soluble vitamins (K,E,D,A) because large amounts
can result in toxicity.
Cont…
Complementary nutrition therapies are becoming more common
for children, especially for those with special health care needs
such as children with Down syndrome, autism spectrum disorder
(ASD), or cystic fibrosis . As part of the nutrition assessment,
practitioners should be knowledgeable about their efficacy
and safety, and help families determine whether
they are beneficial and how to use them.
 Factors Influencing Food
Intake

1- Family Environment
 family is the primary influence
in the development of food habits.
Food attitudes of parents can be strong predictors
of food likes and dislikes and diet complexity in
children of primary school age. Similarities between
children’s and their parents’ food preferences are likely
to reflect genetic and environmental influences .
Cont…
School age children and adolescents who eat more
dinners with their families consume more fruits and
vegetables, less soda, and fewer fried foods than those
who rarely eat dinner with their families.
Unrealistic expectations for a child’s mealtime manners,
arguments, and other emotional stress can have a
negative effect.
Cont…
Meals that are rushed create a hectic atmosphere
and reinforce the tendency to eat too fast.
A positive environment is one in which
sufficient time is set aside to eat, and
conversation that includes all family members is
encouraged.
 2- Societal Trends

Because almost three fourths of women

with school age children are employed
outside the home , children may eat
one or more meals at a child care center
or school.

In these settings all children should have access to

nutritious meals served in a safe and sanitary environment
that promotes healthy growth and development .
Cont…
Because of time constraints, family meals may
include more convenience or fast foods. However,
having a mother who is employed outside the home
does not seem to affect children’s dietary intakes
negatively.
  3- Media Messages

Food is marketed to children by

variety of techniques: television
advertising, in-school marketing,
sponsorship, product placement,
Internet marketing, and sales
promotion.

In a sample more than 40% of

commercials were for food. Of these,
80% to 95% were for items high in
saturated fat, trans fat, sugar, and
sodium.
Cont…
Television viewing and its multiple media cues to eat
have been suggested as a factor
contributing to excessive weight gain in
school age children and adolescents, especially
when there is a television in the child’s bedroom.
 4- Peer Influence

Peer influence increases with age and affects food

attitudes and choices. This may result in a sudden refusal
of a food or a request for a currently popular food.
Such behaviors are developmentally typical. Positive
behaviors such as a willingness to try new foods can be
reinforced. Parents must set limits on undesirable
influences but also must be realistic.
 5- Illness and Disease
Ill Children usually have a decreased appetite and
limited intake. Acute viral or bacterial illnesses are
often short-lived but may require an increase in fluids,
protein, or other nutrients. Chronic conditions such as
asthma, cystic fibrosis, or chronic renal disease may
make it difficult to obtain sufficient nutrients for
optimal growth.
 Nutrition Education

The early years are ideal for providing nutrition information

and promoting positive attitudes about all foods. This
education can be informal and take place in the home with
parents as models and a diet with a wide variety of foods.
Food can be used in daily experiences for the toddler and
preschooler and to promote the development of language,
cognition, and self-help behaviors.
Cont…

More formal nutrition education is provided in

preschools, and public schools. Some programs
have federal guidance and standards that
incorporate healthy eating and nutrition education
for the families involved. Nutrition education in
schools is less standard and frequently has
minimum or no requirements for inclusion in the
curriculum or the training of teachers.
Cont…
Activities and information that focus on real-world
relationships with food are most likely to have positive
results. Meals, snacks, and food preparation activities
provide children opportunities to practice
and reinforce their nutrition knowledge
and demonstrate their cognitive understanding. Involving
parents in nutrition education projects can produce positive
outcomes that are also beneficial in the home.
 Nutritional concerns

Overweight and Obesity

Overweight and obesity among children is a
significant public health problem. The prevalence of
obesity and overweight increased rapidly in the 1990s
and 2000s, .
Although genetic predisposition is an important factor
in obesity development, the increases in the prevalence
of overweight children cannot be explained by
genetics alone
 Cont...

Factors contributing to excess energy intake for the

pediatric population include ready access to eating and
food establishments, eating tied to sedentary leisure
activities, children making more food and eating decisions,
larger portion sizes, and decreased physical activity.
Children eat fast and unhealthy food that contains high
calories.
 Cont...

Obesity in childhood is not a benign condition,

despite the popular belief that overweight children will
outgrow their condition. The longer a child has been
overweight, the more likely the child is to be
overweight or obese during adolescence and adulthood.

Consequences of overweight in childhood include

psychosocial difficulties such as discrimination
 Cont...

a negative self-image, depression, and decreased

socialization. Many overweight children have one or
more cardiovascular risk factors such as
hyperlipidemia, hypertension, or diabetes .
An even more dramatic health consequence of
overweight is the rapid increase in the incidence of
type 2 diabetes in children and adolescents, which has
a serious effect
 Cont...

on adult health, development of other chronic diseases,

and health care costs . Some children with special
health care needs, such as those with Down syndrome,
Prader-Willi syndrome, short stature, and limited
mobility, are at increased risk for being overweight.
Their size, level of activity, and developmental status
must be considered when estimating energy intake and
providing dietary guidance to their families .
As a way for change:-
Prevention of childhood obesity is an important public
health priority . The recommendations include schools
(improved nutritional quality of food sold and served,
increased physical activity, wellness education), health
care professionals (tracking BMI, providing counseling
for children and families), and communities and
government (better access to healthy foods, improved
physical activity opportunities).
 Cont...

Schools are a natural environment for obesity

prevention, which can include nutrition and health
curricula, opportunities for physical education and
activity, and appropriate school meals.
Families are essential for modeling food choices,
healthy eating, and leisure activities for their children.
Parents influence children’s environment by choosing
 Cont...

nutrient-rich foods, having family meals (including

breakfast), offering regular snacks, and spending time
together in physical activity, all of which can be
critical in overweight prevention.
Parents exerting too much control over their child’s
food intake or promoting a restrictive diet may cause
children to be less able to.
Underweight and Failure to Thrive
Weight loss, lack of weight gain, or failure to thrive
(FTT) can be caused by an acute or chronic illness, a
restricted diet, a poor appetite (resulting from
constipation, medication, or other issues), feeding
problems, neglect, or a simple lack of food.
Some experts prefer the terms pediatric undernutrition
or growth deficiency.
 Cont...

Dietary practices also can contribute to poor

growth, including food restrictions in preschool and
school children stemming from parents’ concerns
about obesity, atherosclerosis, or other potential
health problems.
A careful assessment is critical and must include
the social and emotional environment of the child
and any physical findings. If neglect is documented
to be a contributing factor, health professionals are
obligated to report the case to the local child
protective services.
 Cont...
Families should receive support for positive parent-
child interactions, with respect for the division of
responsibility in feeding and avoidance of any pressure
or coercion on the child’s eating. Severe malnutrition
may require carefully planned interventions and close
monitoring to prevent refeeding syndrome. Chronic
constipation can result in poor appetite, diminished intake,
and FTT
 Cont...

Ensuring adequate fluid and fiber intake can help

relieve constipation, improve appetite, and eventually
promote weight gain.
Because the fiber intake of children is often low,
especially in children who are picky eaters, fiber
intake always should be addressed in the evaluation.
Fiber can be increased by adding legumes, fruits ,
vegetables, high-fiber breakfast cereals.
Nutrient-deficiency diseases
disease (and key Symptoms foods rich in key nutrient
nutrient involved)

xerophthalmia blindness from chronic eye infections, liver, fortified milk, sweet potatoes,
(vitamin A) poor growth, dryness and keratinization spinach, greens, carrots, cantaloupe,
of epithelial tissues apricots

rickets (vitamin D) weakened bones, bowed legs, other bone fortified milk, fish oils, sun exposure
deformities
 bone deformities

beriberi (thiamin) nerve degeneration, pork, whole and

altered muscle enriched grains,
coordination, dried beans,
cardiovascular sunflower seeds
problems

(moisten)

Permanent severe
fatigue.

Shortness of breath,
waking up at night.

Swelling in hands
and feet.

(Dry)Muscle
weakness and
fatigue, especially in
the feet with
difficulty walking.

Numbness of the
extremities, and
sometimes a lack of
sensation in them.

Vomiting.
pellagra (niacin) diarrhea, skin mushrooms, bran,
inflammation, tuna, chicken, beef,
dementia peanuts, whole
and enriched
grains

scurvy (vitamin C) delayed wound citrus fruits,

healing, internal strawberries,
bleeding, abnormal broccoli
formation of bones
and teeth

iron-deficiency decreased work meat, spinach,

anemia (iron) output, reduced seafood, broccoli,
growth, Extreme peas, bran, whole-
fatigue grain and enriched
breads
Weakness

Pale skin

Chest pain, fast

heartbeat or
shortness of breath

Headache, dizziness
or lightheadedness

Cold hands and feet

Inflammation or
soreness of your
tongue

Brittle nails
goitre (iodine) enlarged thyroid iodized salt,
gland, poor growth saltwater fish
in infancy and
Dairy products
childhood, possible
mental retardation, Spinach
cretinism
 Dental caries

Nutrition and eating habits are important factors affecting

oral health. An optimal nutrient intake is needed to
produce strong teeth and healthy gums. The
composition of the diet and an individual’s eating
habits (e.g., dietary carbohydrate intake, eating
frequency) and Lack of calcium and vitamin D are
significant factors in the development of dental
caries .
 Allergy

Food allergies during infancy and childhood are more

likely when a child has a family history of allergies.
Allergic symptoms are seen most often as respiratory
or gastrointestinal responses as well as skin responses
but may include fatigue, lethargy, and behavior
changes. There can be confusion about over the
definitions of food allergy, food intolerance, and food
allergy .
 Cont...

food intolerance is difficulty digesting certain foods and

having an unpleasant physical reaction to them. It causes
symptoms, such as bloating and tummy pain, which
usually happen a few hours after eating the food
A food allergy is when the body's immune system reacts
unusually to specific foods. Although allergic reactions are
often mild, they can be very serious. Symptoms of a food
allergy can affect different areas of the body at the same
time. Some common symptoms include: an itchy sensation
inside the mouth, throat or ears
 Heart disease

The roots of chronic adult diseases such as heart

disease, cancer, diabetes, and obesity are often based
in childhood—a phenomenon that is particularly
relevant to the increasing rate of obesity-related
diseases .
 Cont...

To help decrease the prevalence of chronic conditions

government have been promoting healthy eating habits
for children. For most healthy children limiting total
fat to 30% of total energy, saturated fat to 7% to
10%, and dietary cholesterol to 300 mg/day is
recommended. Use of fat-free milk is appropriate for
most children ages 2 years and older
 Cont...
A balanced energy intake, increased intake of fruits
and vegetables, and limiting “extra calories” to 5% to
15% total intake also is recommended for most
children. Fiber intake 14 g fiber/1000 kilocalories is
suggested. For children with dyslipidemia, who are
overweight or obese, or who have “risk factor
clustering” or high-risk medical conditions,
 Cont...

the Expert Panel recommends consideration of the

Cardiovascular Health Integrated Lifestyle Diet
(CHILD-1) as the first stage in dietary change This is
a DASH-style pattern with emphasis on fat-free/low-
fat dairy and increased intake of fruits and vegetables.
Children’s eating habits
According to the findings, which present the dietary habits
of 132 489 children, 78.8% of children eat breakfast,
42.5% consume fresh fruit every day and 22.6%
consume vegetables every day. 10.3% of children
consume sweet snacks and 9.4% soft drinks on a
daily basis. However, there are significant
differences between eating habits from country to
country. Overall, the WHO findings from this study
highlight that action is urgently needed
Cont..
to promote healthy eating habits among children in all the
countries of the European Region, especially to increase
daily consumption of fresh fruits and vegetables. “A
healthy diet includes high consumption of fresh fruits and
vegetables, daily breakfast consumption and discouraging
routine consumption of nutrient-poor foods that are high in
sugars, saturated fats, trans fats and salt,”
Bad &Good nutrition habits:
BAD HABITS
 Overconsumption of foods high in sugar, fat and salt.
 Eating unhealthy snacks.
 Eating when not hungry.
 Refusal to eat vegetables or fruits.
 Eating too fast.
 Being picky eaters (eating a limited diet).
 Eating while watching TV, playing video/PC games, etc.
 Overeating & comfort eating.
 Drinking too much sugary drinks.
 Skipping breakfast and eating at irregular hours.
GOOD HABITS
 Chew your food for at least 10 seconds before swallowing.
 Pack a homemade lunch/breakfast for school, make sure it
includes a nutritious snack (e.g cut fruits, plain or oat biscuits).
 Eat slowly, it takes a few minutes for the brain to realize the
stomach is full.
 Drink a glass of water or have a bowl of soup to avoid
overeating.
 Schedule your meal times/eat on time.
 Get more fiber (e.g whole grains and legumes).
 Eat smaller meal portions.
 Drink more water.
 Eat a variety of food types per meal.
 Choose foods that are steamed, braised or grilled instead
of deep fried.
Nutrition for a healthy life:-

Healthy nutrition is one of the pillars of non-

communicable disease (NCD) prevention.

Poor diets, overweight and obesity are major

risk factors for cardiovascular diseases

and cancer, the 2 main killers in the WHO

European Region.
Family teaching should include:
 Be a good role model, practice good eating habits & prepare
healthier foods.
 Don’t make eating out or ordering outside food into a
habit.
 Avoid giving treats or promising food as a reward.
 Don’t pressure your child to eat something they don’t
like, gradually wean them into it.
 Try to have a bowl full of fresh fruit within easy view and
reach on the kitchen table or bench. You can offer fruit as
a snack or if your child is still hungry after meals.
 Stock your pantry and fridge with plenty of healthy,
nutritious options, and leave the sometimes food on the
supermarket shelves.
 Try to choose fruit and vegetables of different colors,
textures and tastes. The more variety there is, the more
likely it is your child will find something that they’re
interested in eating.
 Get your child involved in planning and preparing
meals. If your child has helped to make the meal,
they’re more likely to eat it.
 Enjoy healthy meals together as a family as often as
possible. Also look for opportunities to eat together at
breakfast and on weekends.
 Turn the TV off while eating.
 Read books that have healthy food messages for your
child – for example, books with pictures of fruits and
vegetables. Get your child to point out different types,
colors, shapes and so on
 Keep healthy snacks handy at home – and try to avoid
buying unhealthy ones.
 Play more, move more, be active together!
Advice for school-aged children good nutrition:
 Eat breakfast every day to help maintain
concentration in class. A typical breakfast includes
a cereal (for example, rice, bread, and oats), protein-
rich food such as egg, a glass of milk and vitamin C
rich fruit e.g. orange, and papaya. skipping breakfast
can have adverse effects on both general energy levels
and cognition of school children.
 Eat a variety of foods in order to
have adequate nutrient intake.
 Balance the food you eat with physical activity.
 Choose a diet with plenty of grain products, vegetables
and fruits.
 Choose a diet low in fat, saturated fat, and cholesterol.
Buy low-calorie and low-fat meals, snacks and deserts.
 Choose a diet that provides enough calcium and iron to
meet their growing body’s requirements.
 Teach children from an early age about nutrition, foods,
drinks, healthy eating and drinking.
 Choose a diet moderate in sugars and salt. Avoid giving
large amounts of sweet deserts, soft drinks, fruit-
flavored drinks, sugar-coated cereals, chips or candy.
Promoting healthy childhoods:
Healthy nutrition during childhood is a fundamental
priority for the future of the Region.
Policy-makers can promote healthy growth and
development among children by:
• regulating marketing of unhealthy foods and
beverages.
• implementing WHO-recommended labelling rules
for nutrition producers.
 incentivizing reformulation of foods high in sugar, fat
and salt.
 introducingfiscal incentives such as implementing a tax
on sugar-sweetened beverages.
 facilitatingaccess to healthy and nutritious food in
schools, other public institutions – through
implementation of healthy public food procurement and
service policies.
 supporting monitoring initiatives of children’s eating
habits, anthropometric measurements and food
environments to monitor policy impacts.
How to manage overeating and undereating:
Overeating:
If you’re concerned that your child has a tendency to
overeat, here are some things to try:
 Offer a slightly smaller portion of food.
 If your child finishes it, you can
offer a small second helping. This gives your
child’s brain and tummy a chance to catch up.
 If your child doesn’t eat part of
the meal for example, the vegies. It isn’t a good idea to
offer extra serves of other food.
•Serve your child’s food on a smaller plate.
This way your child gets the right-sized
portion but still gets a ‘full plate’ of food.
•Avoid distractions like TV or toys during
mealtimes. This will help your child focus on their
appetite.
How to manage Under-eating
• If you feel your child doesn’t eat
enough at mealtimes or doesn’t have an
appetite, you could try the following strategies:
• Offer food around the same times each
day. If children eat at regular mealtimes,
they’re more likely to be hungry at
that time of day.
•Encourage your child to eat more at mealtimes by making
sure you serve small amounts at snack times. One small
snack between regular mealtimes is usually plenty as an
energy top-up, unless your child has been very active.
•Avoid offering your child an alternative if they don’t eat a
meal. Your child might just have a small appetite at the
moment.
How to make a balanced meal for school aged children:
Applying my plate
Consider these nutrient-dense foods:
• Protein. Choose seafood, lean meat and poultry,
eggs, beans, peas, soy products, and unsalted nuts and
seeds.
• Fruits. Encourage your child to eat a variety of
fresh, canned, frozen or dried fruits — rather than fruit
juice. If your child drinks juice, make sure it's 100 percent
juice without added sugars and limit his or her servings.
Look for canned fruit that says it's light or packed in its
own
juice, meaning it's low in added sugar. Keep in mind that
one-quarter cup of dried fruit counts as one cup-equivalent
of fruit. When consumed in excess, dried fruits can
contribute extra calories.

•Vegetables. Serve a variety of fresh, canned, frozen or

dried vegetables. Aim to provide a variety of vegetables,
including dark green, red and orange, beans and peas,
starchy and others, each week.
•When selecting canned or frozen vegetables, look for
options lower in sodium.
• Grains. Choose whole grains, such as whole-wheat
bread, oatmeal, popcorn, quinoa, or brown or wild rice.
Limit refined grains such as white bread, pasta and rice.
• Dairy. Encourage your child to eat and drink fat-free
or low-fat dairy products, such as milk, yogurt, cheese or
fortified soy beverages.
Reference
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