Home / School Age / Nutrition & Fitness / Common concerns

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2-15

Childhood obesity

Years

In 2007, 23% of Australian children were overweight or obese. The number of overweight children nearly doubled between 1985 and 1995, while the number of obese children more than tripled in the same period.

What is childhood obesity? Causes of obesity Consequences of obesity Preventing obesity Common myths about weight Getting further help What is childhood obesity? Overweight and obesity are terms used to describe having an excessive amount of body fat. Obese is a more severe form of overweight. These are officially defined using Body Mass Index (BMI), a scale that identifies healthy, overweight and obese weight ranges. Children and BMI For children, BMI ranges also take into account the age and gender of the child.

did you know

The health problems associated with childhood obesity are very severe. There are concerns that parents of the current generation of Australian children will outlive their children.

You can use a simple BMI calculator and growth charts to see how your childs weight and health are tracking. For more information about your childs BMI, talk to your maternal and child health nurse or doctor.

There are no definitions of overweight and obesity for children under the age of two. The best way to monitor children in this age range is to keep an eye on their growth and development using the standard charts and information about appropriate weight for age. Its also important to discuss this with your GP. Causes of obesity Obesity has many causes. Put simply, its caused by taking in more energy than is used up over a period of time. Research is helping us understand more about an individuals likelihood of becoming overweight or obese, but the most important factors are in our lifestyle. Obesity can be caused by eating too much or eating a lot of 'sometimes' foods. These days we tend

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to eat larger food servings, snack more and consume more high-calorie, low-nutrition food. Problem foods include soft drinks, cordial, juice, chips, lollies and snack bars. Our family background (the genes we inherit from our parents) influences our likelihood of becoming overweight. It also influences the effects of our weight on our health. However, as lifestyle factors have a greater influence on weight gain, changing our behaviour to include healthy habits will make a significant difference to being healthy. Inadequate physical activity is also a key contributor to obesity. Childrens overall physical activity has decreased for the following reasons: Children are less likely to walk or ride bikes to get to places. Parents are more likely to drive their children around. Families spend less time outdoors. Many houses have small backyards. Concerns about safety means that parents now discourage outdoor play, both at home and in public parks. Daily tasks around the house dont require as much physical exertion as they did in the past. Finally, obesity is rising because children are spending too much leisure time on low-energy pastimes, such as watching TV and computer use.

Read more about how much activity kids need and obstacles to physical activity.

Consequences of obesity Childhood obesity has serious consequences for childrens health and wellbeing. These consequences include the following: Adult obesity: there are close links between obesity in childhood and being an overweight or obese adult. Health disorders: these include problems in childhood that have in the past been diagnosed only in adults, such as type-2 diabetes, hip and joint problems and obstructive sleep apnoea. Emotional and social problems: these include teasing and bullying, low self-esteem, poor body image, depression and eating disorders. If children remain overweight there can be physical health problems in adulthood: these include cardiovascular disease, type-2 diabetes, types of cancer, infertility and skin disorders. If a child has been obese since early childhood, associated illnesses and health problems are more likely to occur in adulthood. Preventing obesity There are three main ways to prevent your child becoming overweight or obese: Promote healthy eating at home: keep only everyday foods in the cupboard, avoid or limit sometimes foods, and talk to your child about health and nutrition. Have three meals and

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two healthy snacks a day, always have breakfast and make water their everyday drink. Encourage your child to be active, and develop an active family lifestyle: you dont have to engage in strenuous physical activity all the time - instead, make being active a fun part of your familys daily routine. For example, walk to school or sport, kick a football together in the park, or take stairs instead of lifts or escalators. Getting active can be a great way to spend positive family time together! Limit screen-based activities: make some family rules that set boundaries on the amount of time spent watching TV or playing computer games. Think about limiting screen time, particularly while eating and during daylight hours when it takes away from outdoors time and active leisure.

Remember that children do as you do, so its important to model an active lifestyle and healthy eating patterns. You might also want to see our 12 tips for living well and avoiding childhood obesity.

Common myths about weight There are several myths and misconceptions about weight that are not helpful for parents who want to look after their childs health. It helps to have reliable information and understand the reality of overweight and obesity. Myth Its only puppy fat. Reality Sometimes parents are told their young childs excess fat is normal, that it will disappear as the child grows, and that it isnt a real health concern. This is not the case for most overweight children,who are very likely to become overweight adults. Children will grow into their weight. Sometimes parents believe their child will grow into a more suitable weight. It is true that overweight children often dont need to lose weight, but rather need to maintain their current weight as they grow taller. But this doesnt mean the child can continue to eat unhealthy food and be inactive. If youre worried, keep an eye on your childs weight. Try to slow weight gain by making changes to your familys lifestyle. Seek advice if youre still concerned. Overweight can be caused by genetics. A persons genetic make-up does influence body weight, but genetics cant explain recent increases in weight problems and obesity in Australias population. Families share not only genes but also environment and habits; this means unhealthy eating and lifestyle patterns can also be passed down. No matter what genes a child has, healthy eating and activity habits will result in better health. Overweight can be caused by having big bones or a slow metabolism. Dieting is the best way to bring weight down to a healthy level. Differences in bone weight between individuals are small and dont explain most weight differences. Overweight is related to increased amounts of body fat, not differences in bones. Likewise, any differences in metabolic rate are small and dont account for overweight or obesity. Some people mistakenly believe that dieting is an effective way to lose weight, but a diet usually makes you crave the food youve cut out, so you break the diet. More importantly, a restrictive diet isnt healthy for a growing child. A more effective way to achieve and maintain a healthy weight is to make small changes to eating habits and levels of activity. Keep these

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changes going over time. Altering eating habits significantly can lead to eating disorders. Some people are concerned that promoting healthy weight, eating and activity habits can increase the risk of eating disorders. While restrictive dieting and dramatic weight loss might be associated with eating disorders, nonrestrictive healthy family eating and activity habits dont increase the risk of eating disorders. Families that use positive parenting practices to promote healthy eating and moderate activity actually encourage health and wellbeing in children. Getting further help If you want to discuss your childs eating and activity habits or weight, the following professionals can provide advice and information: your maternal and child health nurse your local GP your paediatrician your local community health centre dietitians (find an Accredited Practising Dietitian) psychologists (find a psychologist).

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GLOSSARY Body Mass Index (BMI) Currently seen as the most appropriate measure of overweight and obesity, calculated by dividing weight (kg) by height squared (m2). type-2 diabetes A condition that occurs when the body either cant use the insulin it produces, or produces insufficient insulin, causing high blood sugar levels. Obesity and inactivity greatly increase the risk of this condition developing. Type-2 diabetes used to be called late-onset diabetes because it mainly affected people over 40. It is now being seen more often in younger people and children who are over their healthiest weight.

More to explore Nutrition and fitness: the basics Choosing good food Food portions Food for preschool and school-age kids Food & recipes Good fat and bad fat: the basics Being active is good for kids Encouraging kids to be active Eating strategies

Web links VicHealth - Obesity and overweight fact sheet (PDF doc: 73kb) Australian Institute of Health and Welfare Overweight and Obesity Royal Children's Hospital Melbourne - Weight management clinical guidelines

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Last updated 05-10-2010

Last reviewed 12-10-2009

Agras, W. S. (2005) Risk factors for childhood overweight. Current opinion in pediatrics,17,648-652. Booth, M. L., Chey, T., Wake, M., Norton, K., Hesketh, K., Dollman, J., et al. (2003). Change in the prevalence of overweight and obesity among young Australians, 1969-1997. American Journal of Clinical Nutrition, 77, 29-36. Commonwealth Scientific and Industrial Research Organisation (2008). Australian National Children's Nutrition and Physical Activity Survey: Main findings. Retrieved 27 November, 2009, from Australian Government Department of Health and Aging: http://www.health.gov.au/internet/main/publishing.nsf/Content/66596E8FC68FD1A3CA2574D50027DB86/ $File/childrens-nut-phys-survey.pdf Epstein, L. H., Myers, M. D., Hollie, M. A., Raynor, A., & Saelens, B. E. (1998). Treatment of pediatric obesity. Pediatrics, 101, 554-570. Lobstein, T., Baur, L., & Uauy, R. (2004). Obesity in children and young people: A crisis in public health. Obesity Reviews, 5(Suppl. 1), 4-104. Luttikhuis, O.H., Baur, L., etal. (2009) Interventions for treating obesity in childhood (Review). The Cochrane Collaboration. Retrieved July 09, 2009 from www.thecochranelibrary.com. Magarey, A. M., Daniels, L. A., & Boulton, T. J. C. (2001). Prevalence of overweight and obesity in Australian children and adolescents: Reassessment of 1985 and 1995 data against new standard definitions. Medical Journal of Australia, 174, 561-564. National Health and Medical Research Council. (2003). Clinical practice guidelines for the management of overweight and obesity in children and adolescents. Canberra: National Health and Medical Research Council. Reilly, J.J., Wilson, M.L., Summerbell, C.D., Wilson, D.C. (2002). Obesity: diagnosis, prevention and treatment; evidence based answers to common questions. Archives of Disease in childhood, 86, 392-394. Swinburn, B. A., & Egger, G. (2004). The runaway weight gain train: Too many accelerators, not enough brakes. British Medical Journal, 329, 736-739.

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Home / School Age / Nutrition & Fitness / Healthy eating

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1-8

Choosing good food

Years

When children eat lots of different healthy foods, they get the nutrients they need for growth and development. It also helps them learn healthy eating habits for life.

Nutritious food for children Fruit and vegies Compounds in fresh fruit and vegetables help protect the body against all kinds of diseases, including cancer. Fruits and vegetables are also full of fibre and water. Grains Most cuisines rely on grains (such as rice, pasta and noodles). They provide an important energy source to the body. Grains with a low glycaemic index give the body slow-release energy. This is why cereals like breads and pasta are the main component of a childs diet. Read the Choice article on glycaemic index (GI) to find out more.

Try adding more wholegrains to your family diet. They provide additional essential nutrients like fibre and magnesium.

Lean meats, fish and poultry These foods and alternatives such as eggs supply vital iron, zinc and vitamin B12 as well as protein. These are things children need to grow. Red meats are an especially valuable source of iron, zinc and B12. Fish is a good source of omega-3 fatty acids, which help the brain to develop. Dairy Dairy is high in calcium, which builds strong bones. Why its important to eat lots of different foods As long as children eat a variety of nutritious foods, its likely they wont be missing out on any important vitamins or minerals. It also makes it less likely theyll be eating harmful amounts of anything. Fish, for example, can contain traces of pollutants such as mercury, which are dangerous in large doses. Its easier for children to make good food choices if you offer them a healthy assortment of food from an early age.

One way to encourage variety, add interest and expand the range of nutrients in your childs diet is for your family to try foods from different cultures and with different ingredients.

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Vegan and vegetarian diets Children require many different nutrients for healthy growth and development. So a vegan diet suitable for adults might not be nutritious enough for the growing bodies of babies and children. You will need to compensate for the lack of vitamins. For example, vitamin B12 is essential for brain development and can only be found in animal products. A vegetarian diet that includes dairy and eggs is fine for most children. If you follow a vegan or vegetarian diet and are concerned about your childs nutrition, consider consulting a dietitian.

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GLOSSARY fibre The parts of vegetables, fruit and cereal that cant be digested. Fibre plays an essential role in keeping our digestive systems healthy. It also helps to lower glucose and cholesterol levels. Adequate fibre intake can help to prevent bowel cancer, diabetes, heart disease and constipation. iron An essential mineral that carries oxygen around the body. It is needed for absorption of B vitamins, calcium and copper. It also boosts immune function. It is found in red meat, wholegrain cereals, liver, kidney, eggs, shellfish, nuts, soy, dark-green vegetables and dried fruit. zinc An essential trace mineral needed for healthy skin, bones and teeth and also for normal development of the brain and nervous system. Zinc is found in seafood, nuts and seeds, wholegrain cereals, pulses, sardines, beef, milk and green vegetables. vitamin B12 A vitamin important for the creation of red blood cells and healthy nerve tissues. It is found in meat (especially liver), fish, eggs, dairy produce, yeast extract and seaweed. Untreated B12 deficiency can result in anaemia and permanent nerve and brain damage. protein An organic compound made up of amino acids and essential for the structure and survival of all living cells. Without protein, we can't grow. Protein deficiency causes tiredness, hair loss, decreased muscle mass, low body temperature and hormonal changes. Protein is found in meat, fish and eggs, as well as dairy products, legumes and wholegrain cereals. omega-3 fatty acids One of the types of essential fatty acids needed to build and repair skin and other tissues in the body as well as for healthy functioning of immune and nervous systems. Omega-3 fatty acids are found in oily fish such as salmon, herring, mackerel, anchovies and sardines, and also in some seeds. Fish oil can be taken as a supplement. The other type of essential fatty acid is omega-6. calcium An essential mineral needed for healthy bones and strong teeth. Sources include dairy products; beans and bean products (like tofu and soy milk); nuts and seeds (including tahini and almond butter); sardines, prawns and salmon (including the tinned and cured versions); oranges; seaweed; wholegrain cereals; and leafy greens. vitamins Organic compounds found in foods. Vitamins are essential to normal physical functioning and healthy living. Lack of vitamins will quickly affect your health. Deficiency in a specific vitamin usually corresponds to specific health issues and diseases.

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minerals Inorganic elements, such as calcium, iron, sodium and zinc, that are essential for the healthy functioning of cell membranes, enzymes, nerve transmission and glandular secretions. vegan Relating to a strict vegetarian diet that excludes all animal products. A vegan is a person eating this kind of diet. vegetarian Relating to a vegetable and grain diet, usually also including eggs and dairy products. A vegetarian is a person eating this kind of diet.

More to explore Baby nutrition: in a nutshell Toddler nutrition and fitness: in a nutshell Preschooler nutrition and fitness: in a nutshell School-age nutrition and fitness: in a nutshell Food portions Vitamins and minerals Vitamin D: what you need to know Cooking with kids Meals in minutes How to get your child to eat vegetables

Last updated 28-11-2009

Last reviewed 12-10-2009

Cooke, L. (2007). The importance of exposure for healthy eating in childhood: A review. Journal of Human Nutrition and Dietetics, 20(4), 294-301. Department of Health and Aged Care. (1998). The Australian guide to healthy eating. Canberra: Australian Government Publishing Service. National Health and Medical Research Council (2003). Dietary guidelines for children and adolescents in Australia. Canberra: Australian Government Publishing Service

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Home / School Age / Nutrition & Fitness / Healthy eating

Suitable for

1-8

Good and bad fat: 12 tips for getting the balance right

Years

Try these ideas to get a healthy balance of good and bad fats in your familys daily diet.

1.

Breastfeeding gives newborns all the essential fatty acids in the correct proportions. If your baby is on formula, check with your doctor that it has an appropriate amount of essential fatty acids (the nutrients in most formulas are very similar to breastmilk). Rice and soy milks are not advisable for newborns.

did you know

To help your children develop a healthy lifestyle, model healthy choices yourself: Eat nutritious food. Dont overdo it on junk food. Stay active.

2.

Give children full-fat foods when they first start on solids. Littlies need to get energy for their big growth spurts from high-fat foods. Reduced-fat dairy does not have enough vitamins and energy for children under two. Skim milk and dairy products should be given only to children aged five years and older.

3.

Offer some reduced-fat milk and dairy products after children turn two, as long as they are getting enough total energy from a wide variety of foods.

4.

Introduce low-fat meals for toddlers and preschoolers. Use a wide variety of foods, and try to include a range of fats in your childs diet. This is the age to start developing habits and food choices for life.

5.

Omega-3 fat occurs naturally in breastmilk, and is added to formula. Once children are no longer breastfeeding or formula-feeding, offer foods such as tinned fish and vegetable oils to ensure they get enough omega-3.

6.

Review your familys daily diet. How many foods do you eat that contain good fats? How many contain bad fats? You should try to limit your intake of saturated fats to about 10% of your daily diet.

7.

Review the nutrition information panels (NIPs) on your packaged food. The NIPs must list saturated fats separately from total fats. This will help you work out how much saturated fat your family consumes daily.

8.

Remove food with bad fats from your family diet. These include fatty cuts of meat, full-fat dairy products, butter, deep-fried foods, commercially produced cakes and biscuits, snack foods and lollies. Replace them with foods with good fats lean meat, low-fat dairy, margarine made from polyunsaturated or monounsaturated fats, nuts, fresh fruit and vegetables. For treats, try our carrot and muesli mini muffins or our strawberry ice blocks.

9.

When youre shopping, choose foods that have the Heart Foundations Tick. In general, foods with the Tick have met strict standards for saturated fat and trans fat. The Tick helps you ensure

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youre making a healthy choice. 10. Set a good example for your children by making healthy food choices yourself. Choose foods with good fat like olive oil, tinned fish, nuts and avocados. Limit processed food. 11. Try to limit sometimes food to once or twice a week. Sometimes food might include takeaway foods, snack and junk foods, cakes and pastries, and ice cream and chocolate. 12. Have fun with food! Trying a range of things can be entertaining and creates a healthy attitude to food.

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GLOSSARY fatty acids A particular class of acids present in animal and vegetable fats and oils. There are two essential fatty acids, omega-3 and omega-6. Essential fatty acids contribute to brain and eye development, and have a role in immune and other vital body functions. Breastmilk contains omega-3 and omega-6 acids, which cannot otherwise be made by the human body. Breastfeeding mothers can increase the amount of omega-3 acids in their milk by consuming fish oil. Unsaturated fat Found in oil and vegetable sources and usually liquid at room temperature. There are two different types of unsaturated fats: polyunsaturated and monounsaturated. Saturated fat Found in animal products and usually solid at room temperature. Saturated fats can increase bad cholesterol levels, reduce good cholesterol and contribute to the risk of cardiovascular disease.

More to explore Good fat and bad fat: the basics Food portions Choosing good food Food & recipes Healthy habits for a healthy life: 12 tips Junk food About breastmilk Bottle-feeding and formula

Web links Australian Guide to Healthy Eating Better Health Channel - Fats and oils

Last updated 14-01-2010

Last reviewed 12-10-2009

Agostoni, C., Marangono, F., Giovannini, M., Galli, C., Riva, E. (2001). Prolonged breast feeding (six months or more) and milk fat content at six months associated with higher developmental scores at one year of age within a breast fed population. Advances in Experimental Medicine and Biology, 501, 137-141. Garrow. J., James, W., and Ralph, A. (2001). Human nutrition and dietetics (10th ed.). Sydney: Churchill Livingstone.

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Heird, W. (2001). The role of polyunsaturated acids in term and preterm infants and breastfeeding mothers. Pediatric Clinics of North America, 48(1), 173-188. Hoffman, D., Birch, E., Birch, D., Uauy, R., Castaneda, Y., Lapus, M., Wheaton, D. (2000). Impact of early dietary intake and blood lipid composition of long chain polyunsaturated fatty acids on later visual development. Journal of Paediatric Gastroenterology and Nutrition, 31(5), 540-553. Innis, S., (2000). The role of dietary n-6 and n-3 fatty acids in the developing brain. Developmental Neuroscience, 22(5-6), 474-480. Lapillonne, A. and Carlson, S. (2001). Polyunsaturated fatty acids and infant growth. Lipids, 36(9), 901-911. Makrides, M., and Gibson, R. (2002). The role of fats in the lifecycle stages : pregnancy and the first years of life. Medical Journal of Australia, 176(Suppl), S111-112. Makrides, M., Hawkes, J., Neumann, M., Gibson, R. (2002). Nutritional effect of including egg yolk in the weaning diet of breast fed and formula fed infants: A randomized controlled trial. American Journal of Clinical Nutrition, 75, 1084-1092. National Health and Medical Research Council (NHMRC) (2003). Dietary Guidelines for Children and Adolescents in Australia Incorporating the Infant Feeding Guidelines for Health Workers. Commonwealth of Australia. SanGiovanni, J., Berkey, C., Dwyer, J., and Colditz, G. (2000). Dietary essential fatty acids, long chain polyunsaturated fatty acids, and visual resolution acuity in healthy full term infants: A systemic review. Early Human Development, 57(3), 165-188. Sherriff, J. (2002). The role of fats in the lifecycle stages: toddlers to preschool. Medical Journal of Australia, 176(Suppl), S113-114. Simopoulos, A. (2000). Human requirement of -3 polyunsaturated fatty acids. Poultry Science, 79(7), 961-70. Sullivan, D., & Carlson, S. (2001). Dietary fats for infants and children. Pediatric Annuals, 30(11), 683. Wainwright, P. (2002). Dietary essential fatty acids and brain function: A developmental perspective on mechanisms. Proceedings on the Nutrition Society, 61(1), 61-69.

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Home / School Age / Nutrition & Fitness / Common concerns

Suitable for

2-15

Healthy habits for a healthy life: 12 tips

Years

You can help your child establish healthy behaviour, eating and activity habits from birth. If these habits are established early as part of your familys lifestyle a natural part of the way you do things you wont have to bring in unpopular rules later.

Maintaining healthy habits from the start can help your whole family avoid lifestyle problems that can occur later in life, such as overweight and obesity, type-2 diabetes, types of cancer and high blood pressure.

Read our articles on childhood obesity and overweight and obesity management in adolescence to find out more about the causes and consequences of obesity and how you can help your child.

1. Promote healthy eating in your home. Children are more likely to develop healthy eating behaviours when theyre given a choice of healthy foods at home, so put healthy foods on your shopping list and prepare nutritional meals and snacks for the whole family. Having fewer unhealthy foods (like soft drinks, chips, lollies and snack bars) in your cupboard means you wont have to police what your children eat. 2. As a family, remind yourselves of the basic foods: fruit, vegetables, wholegrain cereals, lean meats and fish, and low-fat dairy foods. Make your shopping list from these groups so it will be easier to prepare family meals that include them.
Today, 23% of females and 22% of males aged 5-12 are regarded as overweight or obese. If youre concerned about your childs weight, ask your GP about a Body Mass Index (BMI) test. The number of Australian children with obesity nearly tripled from 1985 to 1995. The number of overweight children doubled in the same period.

did you know

You could put up a poster that summarises this information in your kitchen or on your fridge perhaps you and your child could make the poster together. Check out our illustrated guide to food portions.

3. Be aware of serving size, and prepare suitable amounts of food for your family. Preparing the right amount discourages everyone returning for seconds or putting too much on their plates. Children who are allowed to follow their own appetite will generally choose the right amount of food for their needs. 4. Make a distinction between everyday and sometimes foods.

Everyday food is the healthy stuff, while sometimes food is the not-so-healthy stuff thats high in fat or sugar and doesnt have many essential nutrients. You might enjoy this kind of food, but only eat it occasionally. Talk to your child about the difference between everyday and sometimes food. 5. Establish healthy eating routines. Healthy eating isnt only about food choices its also about eating on a regular, predictable basis in a social way. For example, its important to:

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eat breakfast every day eat regular meals and several snacks throughout the day eat meals together at the table or kitchen bench, rather than in front of the TV (many parents also find mealtimes are more pleasant and less stressful when the TV is off) allow enough time so meals can be eaten in a relaxed and unhurried way. 6. Praise children when they choose healthy foods, and remind them of the benefits of healthy eating. Try to avoid nagging or making eating a battle or power struggle. Youre more likely to encourage healthy habits by making mealtimes fun you can do this by giving your younger child some positive feedback (sometimes called descriptive praise). For example, you could try saying, Wow, you picked a banana for morning tea! Delicious. You could also say things like, Drinking milk helps keep your bones strong. Involve your older child in making healthy lunch box and snack selections. Encourage your child to prepare these foods by himself, and ask him to help you prepare family meals. Have a variety of healthy foods available for your child to choose from, so you dont have to worry about his choices. 7. Make physical activity part of everyday life. Many people think being active means playing sport or doing strenuous exercise, but thats only one way of being active. For example, you can encourage your child to walk instead of taking the car a short distance, walk the dog instead of watching TV, and use stairs instead of lifts or escalators in shopping centres. Be a role model and choose being active to show your child how easy it can be. Take a moment to notice and comment when your child chooses everyday physical activity.

Encourage everyday physical activity by saying: Its time to play outside now. The dog needs some practice fetching. Itd be great if you could go outside and throw the ball to her. Lets walk to the shop. Wow, youve been jumping on the trampoline for ages. You did a fantastic job pulling the weeds out of the garden. Its great when you help. You rode a really long way on your bike today. Well done!

8. Enjoy physical activity as a family. You could ride bikes together, or have a family visit to the park to throw a frisbee or kick a football. Talk about these as fun activities rather than exercise. Outdoor play is generally more active than indoor play, so make the most of outdoor time. 9. Give children older children especially opportunities to try different sports and ways to be active. This could include various sports or activities at school or outside school hours. If your child can find a sport or activity she really enjoys, you wont need to push her to be active (on the other hand, sometimes children who are forced to exercise or participate in activities they dont enjoy can develop a negative attitude to physical activity). Support your child by watching her play, and make it easy for her to take part by driving her to games and training. This is great encouragement and can increase the likelihood that your child will stay involved. 10. Limit the time your child spends on screen-based activities, such as watching TV and DVDs, and playing computer and other electronic games. For recommendations on daily time limits, see our article

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on screen time and children. 11. Encourage your child to value his body for what it can do, rather than how it looks. Try not to draw too much attention to your childs weight, even if youre worried about it. If you discuss weight with your child, use terms like healthiest weight, rather than overweight, obese or even fat. 12. Set a good example. Parents who have a healthy diet and are physically active are much more likely to encourage the same habits in their children. Keep in mind the power of modelling your child learns mostly from what you do yourself, not from what you tell her to do. Practise what you preach!

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GLOSSARY type-2 diabetes A condition that occurs when the body either cant use the insulin it produces, or produces insufficient insulin, causing high blood sugar levels. Obesity and inactivity greatly increase the risk of this condition developing. Type-2 diabetes used to be called late-onset diabetes because it mainly affected people over 40. It is now being seen more often in younger people and children who are over their healthiest weight.

More to explore Nutrition and fitness: the basics Choosing good food Food for preschool and school-age kids Food & recipes Fussy eating Junk food Being active is good for kids Encouraging kids to be active Your health

Web links Department of Health and Ageing - Physical Activity Recommendations for Children 0-5 years (PDF doc size: 459kb) Department of Health and Ageing - Physical Activity Recommendations for 5-12 year-olds (PDF doc size: 131kb) Department of Health and Ageing - Physical Activity Recommendations for 12-18 year-olds Go For Your Life

Last updated 05-11-2010

Last reviewed 01-11-2010

Australian Bureau of Statistics (2009)(Reissued). National Health Survey: Summary of Results, cat. no. 4364. Retrieved December 3, 2010, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.020072008%20(Reissue)?OpenDocument National Health & Medical Research Council (NHMRC) (2003). Dietary guidelines for children and adolescents in Australia. NHMRC: Commonwealth of Australia.

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Home / Toddlers / Nutrition & Fitness / Healthy eating

Suitable for

ALL

Vitamin D: what you need to know

Ages

Vitamin D helps bones grow, develop properly and stay strong. Your child can get vitamin D from sunshine and from eating the right foods. If youre worried your child isnt getting enough, this guide will give you some ideas.

Why children need vitamin D Children need vitamin D for bone growth and development. Vitamin D helps us absorb calcium. Serious vitamin D deficiency can cause rickets. Vitamin D deficiency has also been linked to osteoporosis, some cancers, heart disease and diabetes. Babies still developing in the uterus also need vitamin D. If women dont get enough vitamin D during pregnancy, their children might develop neonatal hypocalcaemia (not enough calcium in the blood) or rickets later in childhood. How children can get vitamin D Sunlight When sun specifically UVB radiation shines on our skin, our bodies make vitamin D. We get about 80% of our vitamin D this way. The Cancer Council recommends that: In summer, fair-skinned people can get enough vitamin D from just a few minutes of sun on hands, arms and face every day.

did you know

Its quite common for people to be deficient in vitamin D in winter. In fact, many people lose bone density at this time of year. Increasing vitamin D in your diet can help. Your vitamin D levels during pregnancy will affect your babys bones until your child is around nine years old.

In winter in Victoria and South Australia, 2-3 hours of sun a week will provide enough vitamin D. In winter in Tasmania, more than 2-3 hours of sun a week might be needed (according to recent research). In winter elsewhere in Australia, a few minutes a day will provide enough vitamin D. Note: recommendations aside, there is no conclusive Australian or New Zealand data on how much UVB exposure is needed for children to maintain good levels of Vitamin D.

Too much time in the sun can cause sunburn, skin conditions and even skin cancer. During summer, staying out of the sun altogether between 10 am and 3 pm will help your child stay safe in the sun. The World Health Organisation also has recommendations for avoiding skin cancer based on a UV index.

Diet Most children wont get enough vitamin D from food alone. Vitamin D-rich foods can supplement the

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vitamin D your child gets from sunshine. Foods naturally containing vitamin D include: fatty fish (North Sea salmon, herring, mackerel and sardines) liver egg yolks. Some foods dont naturally contain vitamin D, but have vitamin D added to them. These vitamin Dfortified foods include some margarines and some milks (including fortified baby formula milk). You can also take vitamin D supplements. Vitamin D deficiency Children might be at risk of vitamin D deficiency if they: need to keep all their skin covered (for example, for cultural reasons) have an illness that keeps them indoors use sunscreen in winter in one of the southern states (those living in a hotter state such as Queensland or the Northern Territory still need sunscreen in winter) have a physical or intellectual disability. A Melbourne study found that vitamin D deficiency was high among children with physical and intellectual disabilities. This might be because these children spend more time indoors. It might also be that they have a condition that reduces absorption of vitamin D (such as coeliac disease or cystic fibrosis) have darker skin. In these children, more sunlight is needed to produce the same levels of vitamin D that fair-skinned people produce. People with dark skin who also wear a veil have quite a high risk of vitamin D deficiency have been breastfed for a long time, are dark skinned and have a mother whose vitamin D is low. Signs of vitamin D deficiency include: rickets (bone deformities) delayed motor development muscle weakness, aches and pains fractures. Treating vitamin D deficiency Ask your GP to do a blood test if youre worried your child might not be getting enough vitamin D, or if youre pregnant and think you have low vitamin D. A blood test is the best way to check your levels. If your child has dark skin and does not get enough sun, or if your child cant go in the sun for cultural reasons or because of a skin condition, talk to your doctor about taking supplements. For mild deficiencies: Make sure that your child gets enough sun. Give your child foods that are high in vitamin D or are fortified with vitamin D. If you are breastfeeding and are vitamin D deficient, consider supplementing your breastfeeds with fortified formula.

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If you or your child has a severe deficiency, your doctor will put you on a course of large doses of vitamin D.

Solariums are not recommended as way to improve vitamin D levels or treat vitamin D deficiency. Solariums can cause skin cancer.

Vitamin D, pregnancy and breastfeeding An babys vitamin D stores increase during pregnancy and decline after birth until the baby starts getting vitamin D from sunlight or fortified formula. If pregnant women have low levels of vitamin D, they can pass the deficiency on to their children. Generally, breastmilk is not a rich source of vitamin D. If the mother has low vitamin D while breastfeeding, it can be difficult for the baby to get enough of the vitamin. Cases of rickets are rising in Australia, especially among children with dark skins. This is because darkskinned women particularly those who wear veils have been found to have a high risk of vitamin D deficiency, which is passed on to their newborn children.

Breastfed children of dark-skinned women are at an increased risk of vitamin D deficiency and rickets. For this reason, researchers suggest that these children take vitamin D supplements until they are at least 12 months old.

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GLOSSARY calcium An essential mineral needed for healthy bones and strong teeth. Sources include dairy products; beans and bean products (like tofu and soy milk); nuts and seeds (including tahini and almond butter); sardines, prawns and salmon (including the tinned and cured versions); oranges; seaweed; wholegrain cereals; and leafy greens. Rickets A childhood disease that weakens and deforms childrens bones, and increases childrens risk of fractures. It is caused by a lack of vitamin D. diabetes A disease characterised by high blood sugar levels, which occur when the body cannot produce enough insulin (or produces defective insulin) to process simple carbohydrates and sugar. Diabetes can lead to a higher risk of heart disease and kidney disease, as well as problems with eyes, nerves, feet, legs and teeth. UVB radiation A type of ultraviolet (UV) radiation from the sun. There are three types of UV radiation: UVA, UVB and UVC. Too much UVA causes wrinkles and skin discolouration; too much UVB causes sunburn. UVC is the most dangerous but is blocked by the ozone layer around the earth. Small amounts of UVB are an important way of getting vitamin D. Coeliac disease An illness caused by an intolerance of a protein called gluten, which is found in wheat, rye, barley and oats.

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More to explore Vitamins and minerals Choosing good food About breastmilk Food portions Meals in minutes Eating strategies

Web links Better Health Channel - Rickets

Last updated 28-11-2009

Last reviewed 12-10-2009

Andiran, N., Yordam, N., & Ozon, A. (2002). Risk factors for Vitamin D deficiency in breast-fed newborns and their mothers. Nutrition, 18, 47-50. Australian and New Zealand Bone and Mineral Society, Osteoporisis Australia, The Australasian College of Dermatologists and The Cancer Council Australia. (2007). Risks and benefits of sun exposure: Position statement. Retrieved September 14, 2007, from http://www.cancer.org.au/File/PolicyPublications/PSRisksBenefitsSunExposure03May07.pdf Greenway, A., & Zacharin, M. (2003). Vitamin D status of chronically ill or disabled children in Victoria. Journal of Paediatric Child Health, 39, 543-547. Grover, S. R., & Morley, R. (2001). Vitamin D deficiency in veiled or dark-skinned pregnant women. The Medical Journal of Australia, 175, 251. Holick, M. F. (2002). Vitamin D: The underappreciated D-lightful hormone that is important for skeletal and cellular health. Current Opinion in Endocrinology and Diabetes, 9, 87-98. Holick, M. F. (2004). Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. American Journal of Clinical Nutrition, 79, 362-371. Javaid, M. K., Crozier, S. R., Harvey, N. C., Gale, C. R., Dennison, E. M., Boucher, B. J., et al. (2006). Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: A longitudinal study. Lancet, 367, 36-43. Meier, C., Woitge, H., Witte, K., Lemmer, B., & Seibel, M. J. (2004). Supplementation with oral vitamin D3 and calcium during winter prevents seasonal bone loss: A randomized controlled open-label prospective trial. Journal of Bone and Mineral Research, 19, 1221-1230. Moyad, M. A. (2003). The potential benefits of dietary and/or supplemental calcium and vitamin D. Urologic Oncology: Seminars and Original Investigations., 21, 384-391. Munns, C., Zacharin, M. R., Rodda, C. P., Batch, J. A., Morley, R., Cranswick, N. E., et al. (2006). Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: A consensus statement. Medical Journal of Australia, 185(5), 268. Nowson, C. A., Diamond, T. H., Pasco, J. A., Mason, T. S., Sambrook, P. N., & Eisman, J. A. (2004). Vitamin D in Australia: Issues and recommendations. Australian Family Physician, 33, 133-138. Nowson, C. A., & Margerison, C. (2002). Vitamin D intake and vitamin D status of Australians. Medical Journal of Australia, 177, 149-152. Sinclair, C. (2006). Risks and benefits of sun exposure: Implications for public health practice based on the Australian experience. Progress in Biophysics and Molecular Biology, 92, 173-178. The Cancer Council (2007). A little ray of sunshine - but not too much - important for health. Retrieved September 14, 2007 from http://www.cancer.org.au//Newsmedia/mediareleases/mediareleases2007/17June2007.htm Working Group. (2005). Vitamin D and adult bone health in Australia and New Zealand: A position statement. Medical Journal of Australia, 182, 281-285. Ziegler, E. E., Hollis, B. W., Nelson, S. E., & Jeter, J. M. (2006). Vitamin D deficiency in breastfed infants in Iowa. American Journal of Pediatrics, 18(2), 603.

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Home / School Age / Nutrition & Fitness / Healthy eating

Suitable for

1-8

Vitamins and minerals

Years

We need vitamins and minerals to grow, see properly, and make bones, muscles, skin and organs. They also help us battle infections. If we dont get enough of some vitamins and minerals, it can lead to serious problems.

Eating fresh foods is a better way of getting vitamins and minerals than taking supplements. When children eat a wide range of nutritional foods including vegetables, fruit and grains they usually get all the vitamins and minerals they need. Children who arent eating a wide range of nutritional foods could benefit from eating foods fortified with vitamins and minerals for example, soy milk and breakfast cereals. Which vitamins do we need? How it is destroyed or made unavailable Excessive alcohol intake

Vitamin Vitamin A (retinol)*

How it helps the body

Common sources

Eyesight Bone growth Immune system Skin Lining of respiratory, urinary and intestinal tracts (protects against harmful bacteria)

Liver Fish-liver oil Egg yolks Milk products

Vitamin B1 (thiamine) Nervous system Digestion Muscles Heart Liver Yeast Rice Wholemeal products Peanuts Pork Milk Vitamin B2 (riboflavin) Growth Skin Nails Hair Sensitive lips and tongue Milk Liver Yeast Cheese Green leafy Light High temperatures Alcohol and coffee

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Eyesight Protein, fat and carbohydrate breakdown Vitamin B6 (pyridoxine) Healthy skin Nerves Helping the body absorb proteins and carbohydrates

vegetables Fish

Fish Bananas Chicken Pork Wholegrains Dried beans

Roasting Boiling

Vitamin B12 (cobalamin) Making red blood cells Growing nerves Fish Liver Beef Pork Milk Cheese Vitamin C (ascorbic acid) Immune system Protection from viruses and bacteria Healing wounds Bowel activity Cell lifespan Preventing scurvy Citrus fruits Kiwi fruit Berries Tomatoes Cauliflower Potatoes Green leafy vegetables Capsicum Vitamin D Strong bones and teeth Cod-liver oil Sardines Herring Salmon Tuna Full-fat milk and milk products Sunlight (the action of sunlight on the skin allows our bodies to Mineral oil, taken orally Boiling Light Heat Water Sunlight

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manufacture vitamin D) Vitamin E (tocopherol) Protects cells against damaging free radicals vitamin E is a powerful anti-oxidant Immune function DNA repair Nuts Soya beans Vegetable oil Broccoli Sprouts Spinach Wholemeal products Eggs Heat Oxygen Frost Iron Chlorine Mineral oil, taken orally

* Your body can also create vitamin A from beta-carotene. You can get beta-carotene from carrots, spinach, rockmelon, apricots, mangos, peaches and oats. Beta-carotene has the added advantage of being an anti-oxidant.

Excessive amounts of vitamins can be harmful. If you do decide to give a supplement to your child or take one yourself, be careful not to exceed the recommended dosage. Be particularly careful with vitamin A.

Special circumstances Vegans If your child is vegan, you will have to work harder to make sure your child gets enough vitamins and minerals. This applies to breastfeeding vegan mums, too. Its worth seeking advice from a professional on getting enough nutrients. Vegans are most likely to miss out on vitamin B12. A B12 deficiency can lead to impaired brain development, blood abnormalities and neurological problems. B12 is only readily available from animal products. If youre vegan, you will probably have to take a supplement. Avoiding dairy If youre avoiding dairy foods, you can get calcium which builds healthy bones from green, leafy vegetables in the mustard or cabbage families. These include kale, bok choy, mustard greens, turnip greens and cabbage. Spinach contains oxalic acid, which can stop your body absorbing calcium. Many soy products have added calcium. Need more iron? Iron isnt just in meat. You can get iron from dark-green, leafy vegetables and from wholegrains. Breastfeeding Vitamin D, synthesised by the body from sunlight and required for strong bones and teeth, is sometimes suggested as a supplement for breastfeeding mothers if they do not receive adequate sun exposure. Women who live in cooler climates and wear clothing that covers their entire body, such as a veil or burkha, might want to ask a doctor or a nurse about this.

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Rated

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GLOSSARY vitamins Organic compounds found in foods. Vitamins are essential to normal physical functioning and healthy living. Lack of vitamins will quickly affect your health. Deficiency in a specific vitamin usually corresponds to specific health issues and diseases. minerals Inorganic elements, such as calcium, iron, sodium and zinc, that are essential for the healthy functioning of cell membranes, enzymes, nerve transmission and glandular secretions. protein An organic compound made up of amino acids and essential for the structure and survival of all living cells. Without protein, we can't grow. Protein deficiency causes tiredness, hair loss, decreased muscle mass, low body temperature and hormonal changes. Protein is found in meat, fish and eggs, as well as dairy products, legumes and wholegrain cereals. carbohydrates Natural substances that contain oxygen, hydrogen and carbon atoms. Carbohydrates include simple sugars such as glucose, fructose and lactose, as well as complex compounds such as cellulose, starch and glycogen. The body converts most carbohydrates into glucose, which is absorbed into the bloodstream and gives the body energy. Common foods with a significant amount of carbohydrates are breads, rice, pasta and potatoes. immune system A network of chemicals and cells in the body that protect it from disease-causing bacteria and other foreign substances. The immune system can destroy infected, cancerous or damaged cells. mineral oil A petroleum-derived oil that can be used as a laxative when taken orally. It is often added to baby care items such as perfumed baby oil, lotions and liquid soap. anti-oxidants Substances found especially in dark and colourful vegetables, including beans and spinach. Antioxidants contribute to good health by counteracting the cell damage caused by harmful compounds known as free radicals. Antioxidants are thought to decrease the risk of cancer and other diseases. Eating a broad range of fruits and vegetables is the best way of ensuring you get enough antioxidants in your diet. vegan Relating to a strict vegetarian diet that excludes all animal products. A vegan is a person eating this kind of diet. vitamin B12 A vitamin important for the creation of red blood cells and healthy nerve tissues. It is found in meat (especially liver), fish, eggs, dairy produce, yeast extract and seaweed. Untreated B12 deficiency can result in anaemia and permanent nerve and brain damage. calcium An essential mineral needed for healthy bones and strong teeth. Sources include dairy products; beans and bean products (like tofu and soy milk); nuts and seeds (including tahini and almond butter); sardines, prawns and salmon (including the tinned and cured versions); oranges; seaweed; wholegrain cereals; and leafy greens. iron An essential mineral that carries oxygen around the body. It is needed for absorption of B vitamins, calcium and copper. It also boosts immune function. It is found in red meat, wholegrain cereals, liver, kidney, eggs, shellfish, nuts, soy, dark-green vegetables and dried fruit.

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More to explore Vitamin D: what you need to know Food portions Choosing good food You decide what, your child decides how much Child-friendly fruit and vegies How to get your child to eat vegetables Lactose intolerance Eating strategies

Last updated 05-12-2009

Last reviewed 12-10-2009

Department of Health and Aged Care. (1998). The Australian guide to healthy eating. Canberra: Australian Government Publishing Service. National Health and Medical Research Council (2003). Dietary guidelines for children and adolescents in Australia. Canberra: Australian Government Publishing Service Nozza, J.M., & Rodda, C.P. (2001). Vitamin D deficiency in mothers in infants with rickets. Medical Journal of Australia, 175, 253-255.

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Home / School Age / Nutrition & Fitness / Healthy eating

Suitable for

0-8

Water, milk, juice and soft drinks

Years

Under six months, babies need only breastmilk or formula. After this, you can introduce small amounts of boiled and cooled water. Children can have other fluids after 12 months but fruit juice and soft drinks arent recommended.

Under six months: breastmilk and formula Babies under six months need only breastmilk or formula. There is no need to give water. Dehydration is extremely rare in breastfed babies, as long as they are allowed free access to the breast, which is what health professionals generally recommend. Talk to your health nurse if you would rather your baby had a routine for breastfeeds or formula feeds instead of feeding on demand. After six months: introducing water At this age, you can give your baby small amounts of cooled boiled tap-water in hot weather and if baby seems thirsty. At 12 months, water no longer needs to be boiled clean tap-water is fine. Milk and water are still the best drinks, even after your child has turned one. If you allow free access to water, especially in hot weather or when children are running around a lot, they are much less likely to get dehydrated. To help your child drink adequate amounts of water: Have water on the table at meal and snack times. Keep chilled water in a jug in the fridge. Add slices of lemon or orange or a sprig of mint for interest. In summer, freeze small pieces of chopped fruit in ice blocks and add these to water at snack and mealtimes. Try a water filter if your child doesnt like the taste of your local tap-water. Take filled water bottles when you go out with your child. Cows milk For children over 12 months, full fat cows milk is an excellent source of calcium, protein, riboflavin and vitamin B12.

Reduced-fat milk is not recommended for children under two. Skim milk is not recommended for children under five. This is because toddlers need fat and the fat-soluble vitamins it contains for their growth.

Calcium-fortified soy milk can be used as an alternative to cows milk. And remember, breastfeeding can continue after 12 months, for as long as it suits mother and baby.

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Fruit juice Fruit juice can provide valuable nutrients but it has lots of sugar. Children dont need extra sugar. Its better to eat the fruit instead. If you do want to give your child an occasional treat of fruit juice: Mix it half-and-half with water. Limit fruit juice intake to 150 ml a day for children aged 1-6 years. Limit juice intake to 240-360 ml a day for children aged 7-18 years. Children who drink too much fruit juice can have a poor appetite, diarrhoea, obesity and tooth decay, among other problems.

Water is better than fruit juice, because it satisfies thirst but doesnt contain sugar.

Soft drinks Like fruit juice, soft drinks and cordial contain lots of sugar. Unlike fruit juice, they have few vitamins or minerals. And cola and other soft drinks can contain caffeine, which could make your child extremely excited, then exhausted.

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GLOSSARY calcium An essential mineral needed for healthy bones and strong teeth. Sources include dairy products; beans and bean products (like tofu and soy milk); nuts and seeds (including tahini and almond butter); sardines, prawns and salmon (including the tinned and cured versions); oranges; seaweed; wholegrain cereals; and leafy greens. protein An organic compound made up of amino acids and essential for the structure and survival of all living cells. Without protein, we can't grow. Protein deficiency causes tiredness, hair loss, decreased muscle mass, low body temperature and hormonal changes. Protein is found in meat, fish and eggs, as well as dairy products, legumes and wholegrain cereals. riboflavin A vitamin that helps the body make energy. It is essential for healthy blood, immune response, growth and reproduction, skin, nails, hair growth and eyes. It is found in milk, cheese, leafy green vegetables, liver, yeast, almonds and soybeans. Riboflavin is also known as vitamin B2 and vitamin G. vitamin B12 A vitamin important for the creation of red blood cells and healthy nerve tissues. It is found in meat (especially liver), fish, eggs, dairy produce, yeast extract and seaweed. Untreated B12 deficiency can result in anaemia and permanent nerve and brain damage. vitamins Organic compounds found in foods. Vitamins are essential to normal physical functioning and healthy living. Lack of vitamins will quickly affect your health. Deficiency in a specific vitamin usually corresponds to specific health issues and diseases. minerals

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Inorganic elements, such as calcium, iron, sodium and zinc, that are essential for the healthy functioning of cell membranes, enzymes, nerve transmission and glandular secretions. caffeine A stimulant present in coffee, tea, chocolate, cola and some other soft drinks.

More to explore Introducing drinks Nutrition and fitness: the basics Choosing good food Food portions Healthy habits for a healthy life: 12 tips

Last updated 14-01-2010

Last reviewed 12-10-2009

American Academy of Pediatrics. (2001). The use and misuse of fruit juices in pediatrics. Pediatrics, 107, 1210-1213. National Health and Medical Research Council (2003). Dietary guidelines for children and adolescents in Australia. Canberra: Australian Government Publishing Service. Smith, M.M., & Lifshitz, F. (1994). Excess fruit juice consumption as a contributing factor in nonorganic failure to thrive. Pediatrics, 93, 438-443.

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Home / School Age / Nutrition & Fitness / The basics

Suitable for

1-8

Nutrition and fitness: the basics

Years

Here are some guidelines and practical tools to help you ensure your children eat the right amount of good food, keep fit, and stay healthy.

Five basic nutritional needs Foods to avoid Too much eating or not enough? Seven tips for happy mealtimes Exercise for children A special note about screen time Five basic nutritional needs If you have the following five areas of nutrition covered, you cant really go wrong: 1. Protein builds bodies and keeps children strong and healthy. Try peas and beans (any kind, including frozen baby peas and canned baked beans), eggs, fish, chicken, meat, milk, yoghurt and cheese. 2. Vegetables and fruit contain nutrients and fibre important for a healthy body, inside and out. The more colourful, the better. Offer your child broccoli, green beans, carrots, sweet potato, tomatoes, spinach, and cucumber (with skin). Also try colourful fruits such as peaches, apricots, pears and apples. (Wash fruit and leave the skin on.) 3. Starchy carbohydrates provide energy.The more fibre they contain, the slower they burn. Try fibre-enriched bread, wholegrain rice, couscous, pasta, corn bread, pancakes and low-sugar cereal. 4. Good fats with long-chain polyunsaturated fatty acids build brain and nerve cells. These good fats are found in fish (tinned or fresh), avocado, and vegetable oils such as those made from olives or canola. Try to avoid deep frying in these delicate unsaturated oils. Read more about good and bad fats. 5. Tap water is the cheapest and best source of fluids. Most tap water is fortified with fluoride for strong teeth. Foods to avoid Foods high in salt, sugar or caffeine (found in cola drinks): childrens systems cant handle these foods. Also, soft drinks and fruit juice are expensive, high in sugar and bad for teeth. If you want to offer fruit juice, always mix it half and half with water. Limit daily juice intake to 150 ml for children aged 1-6 years, and 240360 ml for children 7-18 years. Fast foods and junk food: these foods include hot chips, potato chips, doughnuts, biscuits and cookies, cakes, chocolate and sugary sweets. They are low in fibre and nutrients and high in sugar and/or fat. The fat in most of these foods is the less-healthy type, including trans fat. Just say no if your child asks for these foods. Instead, let your child get hooked on good snacks, like grated or thinly

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sliced carrot and sweet baby peas served frozen in a cup. Its fine to offer dessert at the end of a meal sliced fruit is the healthiest option. If you want to serve something special, go for vanilla ice-cream or banana bread. Save the seriously sweet stuff, like chocolate, for special occasions like birthdays.

Children watch what youre eating. You can help them adopt good eating habits by eating well yourself. Try giving up at least one or two items of junk food. If you can keep packaged biscuits and chips out of your house, it could make a very big difference for your child.

Too much eating or not enough? You might worry whether your child is eating enough. Or you might be concerned that your child is eating too much and becoming unhealthy. Appetite It helps to know that children go through growth and activity spurts that influence their appetites. Sometimes theyre really hungry, and sometimes they eat like birds. As long as you offer nutritious food, you can trust your childs appetite to get the balance right. In fact, forcing children to eat (even strongly encouraging them to eat more) can often backfire. Its also a good idea to limit sweets, chips and biscuits. These can interfere with childrens natural appetite for nutritious food.

Sometimes children need to be offered a new food 6-10 times before they taste it and, eventually, eat it. It helps if they see you eating it too! If you still have no luck, try again in 3-6 months.

Tummy talk Knowing the way your tummy talks to your brain can also help you deal with concerns about your child undereating or overeating: Our brains only realise we are full about 20 minutes after the food hits our stomachs. Hunger is partly determined by your child's tummy clock how much your child ate yesterday at the same time. Big meals at regular times actually encourage a big appetite next dinnertime, so you can use that to your advantage either way. You can encourage children who undereat at mealtimes to eat more by limiting grazing (or random snacking). On the other hand, regular healthy snacks can be a great way to reduce overeating at mealtimes. Overeating If youre concerned that your child has a tendency to overeat, you can try slowing it down: Offer half a normal portion of food. If your child finishes it, offer the second half of the meal 10 minutes later. Sometimes this will give your childs brain and tummy a chance to catch up. Offer the most nutritious stuff (lean protein and vegetables) first. This is called food sequencing. Your child doesnt need to eat everything on the plate. Offer a normal portion of starchy carbohydrates (like pasta, bread or potatoes) only after your child has finished the more nutritious foods. (Given a choice, children tend to go for the bread and pasta first. This can fill them up before they get to the more nutritious foods.)

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Undereating You might feel your child is consistently not eating enough at mealtimes. If your child tends to sit happily for about five minutes and then starts fidgeting and loses appetite, try the following strategies: Use food sequencing to get the good stuff into your child first. Lean protein and vegetables first, then carbohydrates like pasta, rice or bread. Let your child wolf down the food (this will let your childs tummy outrun the brain, so your child will fill up a bit more). Your childs tummy clock can help too. If you can make mealtimes the same every day, your child is more likely to be hungry at that time of day.

Heres the key: you decide what healthy food to offer your children, and they decide how much food they will eat.

Seven tips for happy mealtimes 1. 2. 3. 4. 5. 6. 7. Be relaxed about meals, even if your child isnt eating. Mix it up a bit. Sitting at the same table for every meal can be hard going. Try a picnic in the backyard or take dinner down to the beach or park occasionally. Try not to give in to whingeing for alternatives to the meal you have prepared. Offer nothing until the next scheduled mealtime or regular snack time (your child will get the hang of it). Schedule snacking to leave a good space before mealtimes (at least -1 hour). At dinner, try offering the protein and the colourful vegies first, when your child is most hungry. Be calm, firm and consistent.

Exercise for children Walking, running, jumping, throwing, climbing and playing gives your child: strong bones and muscles a healthy heart, lungs and arteries improved coordination, balance, posture and flexibility. It also increases overall metabolism all day long. This reduces the risk of getting overweight or obese, and of developing heart disease, cancer and diabetes down the track. Playgrounds are a great place to burn off some steam and play with others. A special note about screen time Screen time is the time children spend in front of screens, including the TV, DVDs, the computer and even mobile phones. When children watch TV, DVDs or play computer games, theyre usually sitting still and missing out on healthy physical activity. Eating junk food while sitting in front of a screen is a recipe for child obesity. Being overweight is unhealthy and uncomfortable and very unpleasant for a young child. Many child development experts recommend the following: children under two: no screen time at all

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children aged 2-5: no more than one hour of screen time a day children over five: no more than two hours each day. Follow any screen time with an outdoor activity (like a walk to the park). If your child is snacking in front of the screen, keep snacks healthy. A banana, a handful of healthy crackers, thinly sliced carrot or celery sticks are all good options.

For more information, see our article on screen time and children.

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(50 ratings)

GLOSSARY protein An organic compound made up of amino acids and essential for the structure and survival of all living cells. Without protein, we can't grow. Protein deficiency causes tiredness, hair loss, decreased muscle mass, low body temperature and hormonal changes. Protein is found in meat, fish and eggs, as well as dairy products, legumes and wholegrain cereals. nutrients Nutrients are substances that help with growth and metabolism. They include three essential categories: protein amino acids, carbohydrates and essential fats. They also include vitamins, minerals and phytonutrients which have antioxidant properties. fibre The parts of vegetables, fruit and cereal that cant be digested. Fibre plays an essential role in keeping our digestive systems healthy. It also helps to lower glucose and cholesterol levels. Adequate fibre intake can help to prevent bowel cancer, diabetes, heart disease and constipation. carbohydrates Natural substances that contain oxygen, hydrogen and carbon atoms. Carbohydrates include simple sugars such as glucose, fructose and lactose, as well as complex compounds such as cellulose, starch and glycogen. The body converts most carbohydrates into glucose, which is absorbed into the bloodstream and gives the body energy. Common foods with a significant amount of carbohydrates are breads, rice, pasta and potatoes. long-chain polyunsaturated fatty acids (LCPs) A group of fatty acids present in animal and vegetable fats and oils, including omega-3 and omega-6 acids. Fatty acids contribute to brain and eye development, and have a role in immune and other vital body functions. trans fat A type of unsaturated fatty acid found in partially hydrogenated vegetable oils (also known as shortenings, and including margarines). These oils are commonly used in processed and junk foods. Research suggests links between trans fats and heart disease, obesity and diabetes. Trans fat is more correctly known as trans fatty acid. metabolism The chemical processes in the body by which food is consumed by cells and broken down into simpler compounds to provide energy. diabetes A disease characterised by high blood sugar levels, which occur when the body cannot produce enough insulin (or produces defective insulin) to process simple carbohydrates and sugar. Diabetes can lead to a higher risk of heart disease and kidney disease, as well as problems with eyes, nerves, feet, legs and teeth.

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More to explore Food portions Choosing good food Meals in minutes How to get your child to eat vegetables Healthy habits for a healthy life: 12 tips Good and bad fat: 12 tips for getting the balance right Teeth development

Last updated 13-01-2010

Last reviewed 12-10-2009

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