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Nutrition for Children and Teenagers

Nutrition for school-age children

Nutrition for Children and Teenagers School-age children and teenagers are much more independent when it comes to making food choices. Children and young adults need a different type of guidance. No matter what their age, learning the importance of a healthy diet and a healthy weight is essential to good health and growing into a healthy adult.

School-age children are no longer toddlers yet not quite teenagers. At this age they are beginning to eat away from home and make their own food choices more frequently. Children at this age grow at a rapid pace.

Children need the same nutrients as adults but in different amounts. Just as for adults, it is important for growing children to eat a variety of foods from each food group to ensure optimal intake of all vitamins and minerals.

A well-nourished and fit child is better able to learn and has more energy, stamina, and self-esteem. A healthy eating pattern along with regular exercise helps children to get fit. The calorie needs of school-age children vary greatly and depend on growth rate, activity level, and body size. All children need at least the lowest end of the serving range from each food group in the Food Guide Pyramid. Most school-age children need about 1,000 to 2,200 calories each day. The table below gives the number of servings in each food group for this caloric intake.

Number of Servings for Kids Ages Six to Twelve

Food Group Number of Servings* Bread, cereal, rice, and pasta 6-9 Vegetables 3-4 Fruit 2-3 Milk, yogurt, and cheese 2-3 Meat, poultry, fish, dry beans, eggs, and nuts 2-3 (about 5-6 ounces)

*Children may prefer smaller servings. Serving several smaller serving sizes can still add up to the total recommended number of servings for the day.

Eating at School
For school-age children, school meals can contribute significantly to overall daily dietary intake. Some children may bring their lunch from home, while others may participate in the school lunch program. The National School Lunch Program, regulated by the U.S. Department of Agriculture (USDA), provides about a third of the RDA for students. Children from low-income families are eligible for free or reduced-price meals.

Fact: Children grow rapidly during these years—typically, they grow one to two feet in height and almost double their weight from six to twelve years of age.

School meals are planned to help moderate fat intake and offer more fiber through whole grains and fresh fruits. It is a smart idea to become familiar with the menu if your child participates in the school lunch program. If your child carries a lunch to school, pack lunches that are pleasing and fun to eat, as well as healthy, safe, and nutritious. A well-balanced packed lunch might include a sandwich with whole wheat-bread and a lean, protein-rich filling, such as turkey chicken, tuna, egg, cheese, or peanut butter; fresh fruit and/or vegetables; low-fat or fat-free milk; and graham crackers, Jell-0, or another simple low-fat dessert. Be aware of food safety measures when packing your child's lunch, such as keeping perishable foods well chilled.

Eating After School
School-age children consume snacks primarily after school. After-school snacks can be a nutritious way to make sure children get the energy and nutrients they need to properly fuel their bodies and to ensure proper growth and development. Snacking can be part of a healthy diet if snacks are chosen correctly. It is another opportunity to incorporate needed food groups into the child's daily diet.

Some speedy after-school snack ideas include the following:

• Bagel or English muffin pizza
• Shaker pudding. Pour 2 cups of milk into a jar with a lid, add 1 small box instant pudding mix, and shake for one minute.
• Tortilla rollups. Roll a tortilla with shredded cheese, microwave until cheese is soft, and dip in salsa.
• Peanut butter on a mini bagel
• Cereal topped with fruit and milk
• Cheese and crackers
• Fruited yogurt topped with granola
• Cut-up vegetables dipped in low-fat ranch salad dressing
• Sunflower seeds
• Pretzels
• Banana pops. Peel a banana, dip it first in yogurt and then in crushed breakfast cereal or granola; freeze.
• Celery with low-fat cream cheese
• Peanut butter on graham crackers
• Fresh fruit (cut up and ready in a bowl, easy to grab and eat)
• Low-fat string cheese
• Breakfast bars
• Banana or apple topped with peanut butter
• Fruit shake-up. Put ½ cup low-fat yogurt and 1/2 cup cold fruit juice in an unbreakable, covered container. Shake it up and pour it in a cup.

The dilemma of overweight childrenThe percentage of overweight children, ages six to seventeen years, has doubled in the United States since 1968. A National Health and Nutrition Examination Survey conducted from 1988 to 1994 by the National Center for Health Statistics found that one in five children in the United States was overweight. Studies also show that almost 70 percent of overweight kids ages ten to thirteen will be overweight or obese as adults.

ALERT! An increasing number of teenagers are also overweight, and, if no intervention is made, approximately 80 percent of them will stay overweight or become obese as adults.

Children and teens will probably experience psychological and emotional fallout from being overweight as youngsters. They may struggle with self-esteem, and they often become the object of teasing from other children. Overweight children are also put at risk for health problems. Studies show that overweight children tend to have higher levels of blood sugar, blood pressure, and blood fats.

Children can become overweight for a variety of reasons. The most common are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination. In rare cases, a medical problem can cause a child to become overweight.

Assessing whether a child's weight puts him or her in an overweight category can be difficult, because children grow in erratic spurts. If you feel your child or teen may be overweight, consult your family physician, Your doctor may use growth charts to determine if there is a problem.

Handling an Overweight Child
Children and teens should never be placed on a calorie-restricted diet to lose weight unless they are under the strict supervision of a doctor for medical reasons. Limiting what children or teens eat can be harmful to their health and can interfere with proper growth and development. It can also be psychologically stressful for a child. Helping the child to adopt healthy eating and exercise habits is more important than pounds lost. Behavior modification strategies have shown considerable success in effecting long-term weight loss. The best programs incorporate plenty of physical activity and healthy eating, including slowing the rate of eating, limiting the time and place of eating, and teaching problem-solving through exercises. The most effective treatments also involve parents.

To help your child achieve a healthy weight, try the following techniques:

• Seek the advice of a health-care professional, such as a registered dietitian or doctor. Keep in mind that adult approaches to weight loss are not fit for children.
• Give your children support, acceptance, and encouragement, no matter what their weight, and talk to them about their feelings. This will help them carry a positive self-image, making weight loss more achievable.
• Starting in early childhood, teach children proper nutrition, selection of healthy low-fat snacks, and the importance of physical activity.
• Monitor the time they spend watching television or sitting at a computer.
• Make it a point to include good nutrition, and make exercise a family affair. Plan lower-fat meals for the entire family, have more nutritious snacks in the house, and plan family activities. This will help the child feel part of the family instead of isolated (not to mention that the whole family will benefit!).
• Beware of using food as a reward for a certain accomplishment, as a substitute for affection, or as a compensation for a disappointment. Use other avenues as rewards.
• Make sure your child's portions are a child's (as opposed to an adult's) size. Use smaller plates for children so you or the child is not tempted to fill up a large plate.
• Explain to children how to recognize when their body tells them that they are hungry or full.
• Stock your kitchen with low-fat and low-calorie snack foods so they are available when the child is hungry. Be wary of bringing high-fat, high-calorie foods into the house and having them within sight of the child.

ALERT! Although limiting fat intake may help prevent excess weight gain in children, it is not recommended to restrict fat intake in children who are younger than two.

• Instead of heavy snacking, make meals their primary source of calories.
• Do not encourage continued eating or cleaning their plates when children are truly no longer hungry.
• Avoid labeling foods as "good" or "bad." Instead, help your child to learn how to fit all types of food into a healthy eating pattern, and teach them how to eat foods in moderation. Even if your child has a few pounds to lose, he or she can still eat foods such as sweets in moderation. What counts is their diet as a whole.
• Make a family rule that eating is only allowed in the kitchen or dining room to keep kids from snacking on high-calorie foods while watching television. Children will most likely eat less with this rule in place.

Feeding your teenBy the time a child reaches the teen years, he or she has a major influence on food choices. Compared to when they were in their childhood years, teens are probably eating away from home more often than just at school. Teens understand the basics of good nutrition, but many stray due to peer pressure, work and school schedules, the need to test independence, lack of discipline, lack of a good example at home, or obsessions with an unrealistic body weight. As with adults or children, the Food Guide Pyramid is also a guideline for teens. Because of an increased need for calories, teens need to increase their number of food group servings to meet their nutritional needs. Teenage boys from ages eleven to fourteen need about 2,500 calories per day, and boys ages fifteen to eighteen need about 2,800 calories. Refer to the table below to find the appropriate number of servings for this caloric range.

Number of Servings for Teenage Boys

Food Group Number of Servings* Bread, cereal, rice, and pasta 10-11 Vegetables 4-5 Fruit 3-4 Milk, yogurt, and cheese 3 Meat, poultry, fish, dry beans, eggs, and nuts 2-3 (about 6-7 ounces)

*Teens will probably eat servings more closely resembling the size of an adult serving.

On average, teenage girls need 2,200 calories per day from ages eleven to eighteen. See the table below for the number of servings from each group that girls in this category require.

Number of Servings for Teenage Girls

Food Group Number of Servings* Bread, cereal, rice, and pasta 9 Vegetables 4 Fruit 3 Milk, yogurt, and cheese 3 Meat, poultry, fish, dry beans, eggs, and nuts 2 (about 6 ounces)

*Teens will probably eat servings more closely resembling the size of an adult serving.

Teens' Special Needs
Two nutrients typically come up short in a teen's diet: calcium and iron. This usually happens due to poor eating habits, poor food choices, or not eating enough. Calcium-rich foods are vital to ensure strong healthy bones. Even as teenagers reach their adult height, bones continue to grow stronger and denser. Almost half of your bone mass as an adult is formed during the teen years.

What else can teens do for healthy bones? Besides eating a diet rich in calcium, including milk, cheese, yogurt, and calcium-fortified foods, teens should participate in weight-bearing physical activities. These may include running, tennis, soccer, dancing, volleyball, or inline skating. These types of activities trigger the formation of bone tissue. Also, they should go easy on soft-drinks, especially caffeinated ones, and avoid smoking.

Fatigue can be a sign of iron deficiency. When iron is in short supply, less oxygen is available to produce energy. Iron needs increase during the teen years. Girls need more iron to replace losses from their menstrual blood flow, and both boys and girls need more iron due to more muscle mass and greater blood supply. Iron comes from foods such as meat, poultry, seafood, legumes, enriched grains, and some vegetables.

It is important for teenagers to eat at least three meals per day to ensure they are consuming all needed nutrients. A meal skipped on occasion is not a concern, but skipping meals on a regular basis can mean missing out on essential nutrients.

Being physically active is just as essential to teenagers as it is to adults. One reason teens are not as active these days is too many sedentary activities, such as television; too many hours at the computer; and video games. Helping teens establish a lifelong habit of being physically active can help reduce their risk now for chronic health problems later in life. Keep in mind that you are a role model for your teen!

Essential: Boys and girls ages seven to ten need about 10 mg of iron daily. For girls during adolescence, ages eleven to eighteen years, the need jumps to 15 mg daily. For boys during adolescence, ages eleven to eighteen years, the need jumps to 12 mg per day.

Eating disordersThe teenage years can be difficult for both boys and girls. To most teens, their looks are extremely important, with the main focus usually being body image. Often, teens have unrealistic notions about the way their body should look. Boys usually put more emphasis on exercising, especially with weights. Teenage girls tend to diet as an approach to finding the perfect body. This usually involves some type of fad diet, and that can be very dangerous, especially during the adolescent years. Excessive concern about weight can also lead girls to engage in unhealthy behaviors, such as excessive exercise, self-induced vomiting, and the abuse of medications such as laxatives or diuretics.

Being obsessive about weight can result in various eating disorders. It is estimated that one million or more Americans suffer from some type of eating disorder. Eating disorders are more than a food problem and are linked to psychological problems.

Anorexia and Bulimia
Anorexia nervosa is a common eating disorder, which usually begins at the age of fourteen or fifteen (but can occur at a younger age), with another peak in incidence in eighteen-year-olds. It is more common in adolescent girls, but it is also found in boys and its incidence has been increasing. Anorexia causes an overwhelming fear of being overweight and a drive to be thin, leading to self-induced starvation or a severe restriction of calories that can lead to being severely underweight. Anorexia is linked to menstrual irregularity, osteoporosis (brittle bone disease) in women, and a greater risk of early death in both men and women.

Bulimia is another eating disorder marked by a loss of control and binge eating, followed by purging behaviors. The person gorges on high-calorie foods and then intentionally vomits or uses laxatives or diuretics.

Signs to Watch For
Factors that you should look for if you suspect that your child has an eating disorder include the following:

• Low self-esteem
• Recent weight loss of 15 percent or more of normal body weight, with no medical reason
• A fear of gaining weight or of being overweight
• Purging behaviors (vomiting or using diuretics—water pills—or laxatives to lose weight)
• Having a distorted image of their body size or shape (for example, believing they are overweight even though they are at a healthy weight or even underweight)
• A preoccupation with thoughts of food, calories, and weight
• Restrictive eating patterns such as frequently skipping meals, fasting, or eliminating entire food groups
• Preference for eating alone
• For young women, amenorrhea (absence of menstrual cycles) or delayed onset of puberty
• Being underweight, with a body mass index that is below normal
• Exercising compulsively
• An extreme denial of possibility of eating disorder
• Withdrawal from friends and family
• Wearing bulky clothing to hide weight loss
• A recent or past event in their life that was very stressful

You should have your child seen by a physician as soon as possible if you think she or he might have an eating disorder. Eating disorders can cause extreme undernourishment and even death. The best treatment for eating disorders combines medical, psychological, and nutrition counseling.

The college yearsBy the time college rolls around, food choices are completely up to the young adult. College can be a time of rush, rush, rush, and not having enough time or money for good eating habits. College dorm life is a particularly toxic food environment, with limited cafeteria food choices, vending machines, a general lack of nutritional consciousness, and the ease of getting deliverable foods like pizza. College life can bring on sloppy eating habits as well as a lack of exercise habits, not to mention some alcohol and partying. Along with all the other changes that college brings, changes in eating habits are sure to happen. It is not unusual for the college freshman to put on an extra 15 pounds during the first year at school.

Skipping Breakfast
One of the number-one mistakes college kids make is skipping breakfast. As we have discussed before, breakfast is the most important meal of the day. When you wake up in the morning, your body has gone for about eight hours with no food or fuel. Breakfast can be a bagel and juice in your room or on the way to class; whole-grain cereal, fat-free milk, and fruit in the dining hall; or even a hot meal. Breakfast can help get your brain and body ready for your hectic day, and make you less likely to snack on high-fat, high-calorie foods between classes due to midmorning hunger attacks. Breakfast can also keep you more awake and alert for those early morning classes!

Campus Dining Halls
Campus dining halls are filled with both healthy and not-so-healthy foods. The key is learning what to choose.

At breakfast, stick with whole-grain cereals, bagels, toast, and other starches with low-fat toppings. Top your cereal with fresh fruit and top it off with fat-free milk. Choose low-fat yogurts for added calcium and egg whites or hard-boiled eggs for added protein. Avoid sugary cereals and higher-fat breakfast foods like doughnuts, Danish, bacon, sausage, or eggs fried in fat. Some of those may be quicker to prepare but are full of fat, sugar, and extra calories. These types of food will put on the pounds and not keep you satisfied as long.

Essential: If you visit the salad bar, avoid too much fat and too many calories: use only a small amount of low-fat or fat-free salad dressing; avoid vegetable salads made with mayonnaise; use only a sprinkling of cheese, nuts, or seeds; use legumes such as garbanzo beans or kidney beans for added protein; and fill up your bowl with fresh, plain veggies.

At lunch, visit the deli section and choose a whole-wheat pita stuffed with plenty of veggies and some lean roast beef, turkey, or ham. Add some light mayonnaise or mustard. Tuna salad or chicken salad can be high in fat and calories because it's often made with too much mayonnaise and too little tuna or chicken. If you love tuna, try getting just half a scoop at the cafeteria, then add some dry tuna from the salad bar. If you love chicken, opt for a grilled chicken breast. Top lunch off with a low-fat yogurt and/or glass of fat-free milk.

Keep the amount of protein to about 6 ounces for the entire day. For dinner, stick to entrees that are grilled, baked, steamed, broiled, stir-fried, or poached. Eat plenty of lean meat, such as skinless chicken or turkey breast, fish, and even on occasion a small portion of lean red meat. Choose less often foods that are fried, breaded, pan-fried, or full of cheese. For side dishes, head to the salad bar again and heap that plate with a garden patch of veggies with light dressing. As for side dishes, choose a baked potato with salsa or steamed vegetables more often than French fries, onion rings, hash browns, or fried potato skins. Avoid creamy soups and sauces that are loaded with saturated fat and calories. Take some fruit for snacking later, or buy canned, single-serving fruit packed in juice for late-night snack attacks.

For breakfast, try any of these food combinations:

• Bowl of whole-grain cereal, fat-free milk, banana, and orange juice
• Toasted bagel with peanut butter
• Oatmeal with sliced peaches and grapefruit juice
• Pancakes or waffles topped with sliced strawberries and a small amount of syrup, and fat-free milk
• Hard-boiled egg, whole-wheat toast with jam, and a glass of tomato juice
• Vegetable omelet, fresh fruit salad, and fat-free milk
• Scrambled eggs and ham rolled in a flour tortilla, orange juice, and low-fat yogurt

Healthy choices for lunch include the following:

• Turkey breast or lean ham sandwich on a whole-wheat bagel with mustard and baby carrots, and low-fat yogurt topped with granola
• Baked potato topped with broccoli and salsa, an apple, and fat-free milk
• Grilled chicken sandwich on whole-wheat pita bread with honey-mustard sauce and lettuce/tomato, low-fat yogurt, and tomato juice
• Large tossed salad topped with low-fat or fat-free dressing, chickpeas, assorted fresh veggies and sunflower seeds, bread stick, and fresh strawberries
• Grilled vegetables with low-fat cheese wrapped in a flour tortilla and fresh fruit cup
• Peanut butter and jelly sandwich on whole-wheat bread, bowl of vegetable soup, and an orange
• Bean soup, pita bread, side salad, and fat-free milk

Good ideas for dinner include these:

• Grilled boneless, skinless, chicken breast topped with salsa and low-fat cheddar cheese, brown rice, green beans, and a glass of fat-free milk
• Veggie burger on a whole-grain bun, side salad, and fresh fruit
• Chicken burrito with salsa, side of vegetables, and an orange
• Broiled fish, steamed vegetables, red potatoes, and angel food cake
• Chicken fajitas with salsa and frozen yogurt
• Vegetarian chili, side salad, and fresh fruit
• Vegetable pizza, side salad, and fresh fruit
• Pasta with marinara sauce and zucchini sprinkled with parmesan cheese and fruited Jell-0

Wrong food choicesFor many young adults, going away to college is their first experience with actually living away from home. They are now completely in charge of taking care of their own meals. There are many tempting substitutes that can take the place of good healthy meals and snacks.

Vending machines can be tempting when you are on the run from class to class. Take a look before you push the buttons. The majority of those tempting treats are full of fat and calories. For instance, a Twix bar contains 14 grams of fat and 280 calories; Peanut M&M's contain 11 grams of fat and 200 calories; a Mr. Goodbar contains 17 grams of fat and 270 calories; cheese peanut-butter crackers contain about 11 grams of fat and 210 calories; and a small bag of potato sticks contains 18 grams of fat and 250 calories. Better choices might include low-fat popcorn, pretzels, animal crackers, fig bars, low-fat granola bars, whole-wheat crackers, or low-fat breakfast bars. If you are trying to satisfy a sweet tooth, choose licorice, Lifesavers, gummy bears, or Rice Krispies bars, and eat them in moderation. They don't contribute to your nutritional intake, but they are at least generally low in fat and calories. Most of the treats found in vending machines will not hold you over for long because of their sugar content.

Essential: To save money and snack on something healthier than what you'll find in vending machines, carry a piece of fresh fruit or a granola bar with you for between-class snacking.

The other popular type of vending machine sells soft drinks. A regular twelve-ounce soft drink has about 150 calories, all coming from sugar. Save your money and carry a bottle of water with you. If water doesn't do it for you, choose a diet soft drink or something made with 100 percent fruit juice.

Fast-food and late-night ordering are very popular among college students. Both are quick and convenient. Remember that if you are short on cash, fast food is not exactly a bargain. Late-night munchies usually consist of ordering those extra large pizzas with everything on them, or sitting down with a bag of Doritos at 2:00 A.M. Your body needs fuel throughout the day to keep your energy levels up and keep you alert. Keep in mind that calories eaten during the day are more likely to be burned off than calories eaten just before bedtime, because you burn more calories when you are active. Try to stick to regular mealtimes; if you snack at night, make them light snacks. Go ahead and order pizza on occasion for a meal, but watch your toppings, which add most of the fat and calories.

Alcohol can be a culprit in those extra pounds gained as a freshman. If you are of legal drinking age, having a few occasional drinks is all right. But keep in mind that alcohol is high in calories and can also lead to late-night munchies. Another reason to drink in moderation is to avoid the effects it has on you the next day, such as headache, fatigue, nausea, and just feeling lousy. This can make it hard to concentrate in classes or to complete class assignments.

Fact: A twelve-ounce beer is 150 calories; a light beer is about 100 calories; a five-ounce serving of wine is about 105 calories; a shot (1.5 ounces) of whiskey is about 100 calories; and a 4.5 ounce Pina Colada is about 250 calories.

Healthy College Eating 101
Just because you are away from home does not mean it is time to forget all the good nutrition habits you learned as a kid. You may just need a bit of a refresher. Try these tips:

• Remember to eat three meals every day, including breakfast. It may seem like you can function on caffeine alone, but if you routinely skip meals, your brain and body will fail you when you need them most.
• Carry a water bottle with you everywhere you go. That way you can save money by not buying soda and other sweetened beverages, avoid unwanted calories, and ensure that you're well hydrated.
• Grab a piece of fruit every time you leave the dining hall, and carry it with you for a quick snack on the go.
• Take a balanced multivitamin every day with breakfast, just to ensure you are getting what you need. Don't let a supplement take the place of healthy foods, just let it round out your daily diet.
• Take a quick trip to the grocery store so you can keep quick nutritious snacks in your room: pretzels, low-fat popcorn, high-fiber crackers, low-fat breakfast bars, and unsweetened breakfast cereal. Buying snacks at the grocery store instead of the vending machine will save you money too!
• Invest in a small dorm room refrigerator to keep other healthy snacks such as fat-free milk, low-fat yogurt, low-fat string cheese, and fruits and vegetables. This way, when you are in a pinch for time, you still have something healthy to eat.
• Avoid keeping high-calorie foods such as candy and cookies in your room. This makes it way too easy to snack on these foods all day long!
• Eat a variety of different foods. There is more than macaroni and cheese, peanut butter and jelly, and ramen noodles out there, so expand your horizons. Spend your dollar wisely, but be sure to include fruit, vegetables, whole grains, lean protein, and low-fat or fat-free dairy products every day.
• Make it your goal to try one new food each week. Experiment with vegetarian meal options such as veggie burgers. Share your meal with a friend so you can both experience something new. Or both of you can get something different and try each other's!

Basically, take care of yourself all the way around, and get plenty of sleep and exercise.