Nutritional requirements for children

Food and drink provide the energy and nutrients that everyone needs to be healthy. Throughout our different life stages, our nutritional needs change to take into account the extra demands placed on our bodies by these changes.

From birth, adequate nutrition is vital for physical growth and development, mental development and cognitive function, for preventing diseases, supporting a healthy immune function and for overall health and wellbeing. This is why it is crucially important that all children have access to a healthy and nutritious diet as a lack of important vitamins and minerals can lead to serious illnesses and developmental issues.

A healthy diet with the right nutrition also plays a vital role in maintaining a healthy weight in children. Research shows that children above a healthy weight are more likely to be above a healthy weight as adults which can lead to health problems in later life. Conversely, if a child is underweight meaning that they are below the expected weight range for their height and age, this can potentially lead to health issues and can negatively impact their growth and development.

In this article we will look at the importance of understanding the nutritional requirements for children at various stages of their development and of recognising how to ensure that children are getting the correct amount of nutrients from their diet to meet their body’s regular nutritional needs.

Why is a healthy diet important for children?

During childhood, children experience rapid physical and cognitive growth, and they need a variety of nutrients to support this process. Nutrients are substances in food that the body uses for energy, growth, and repair. These nutrients are vital for building strong teeth, bones and muscles, supporting brain development, developing a strong immune system to fight off sickness and for maintaining a healthy weight. They are crucial for maintaining health and preventing deficiencies.

Nutrient deficiencies may occur in children who do not eat a balanced diet and this can have serious effects on children because their bodies and brains are still growing. These effects may include making children more prone to infections, poor bone and / or brain development, slow growth and / or a weakened immune system, and can affect a child’s energy levels, mood, and school performance. Nutrient deficiencies and poor diet may also be associated with behavioural problems, problems with emotional and psychological development and poor concentration.

Whilst most foods do contain some nutrients, some foods, such as processed foods, are low in nutrients or may even lack essential nutrients. Eating a healthy, balanced diet means eating a wide variety of foods in the right proportions, and consuming the right amount of food and drink to achieve and maintain a healthy body weight. Evidence shows that children in the UK are eating too much saturated fat, sugars and salt and too little fibre, fruit and vegetables.

This can cause energy spikes and crashes in a child, can affect their mood, focus, and even sleep patterns. Too much sugar can lead to unhealthy weight gain, increase the risk of type 2 diabetes and cause tooth decay. Too much salt can raise blood pressure, even in children, putting stress on their heart and kidneys.

It is crucial to begin practicing healthy eating habits early on in a child’s life as bad habits are hard to break. When children observe and experience good healthy eating habits instilled by their parents / carers, they are more likely to stick and to become a lifelong habit.

Government guidelines for children’s nutritional requirements

The UK government guidelines for children’s nutritional requirements are based upon the Eatwell Guide. The Eatwell Guide applies to most people regardless of weight, dietary restrictions / preferences or ethnic origin. However, it doesn’t apply to children under 2 because they have different nutritional needs; we will look at these later in this article. The Eatwell Guide divides the foods and drinks we consume into five main groups:

• Fruit and vegetables – this should make up just over a third of the food we eat and it is recommended that we eat at least five portions of a variety of fruit and veg each day
• Carbohydrates – this should make up just over a third of the food we eat and includes starchy food such as potatoes, bread, rice, pasta etc. and it is recommended choosing higher-fibre, wholegrain varieties where possible
• Dairy and alternatives – these are good sources of protein and vitamins, and they are also an important source of calcium and includes food items such as milk, cheese, yoghurt and fromage frais etc. and dairy alternatives include food items such as fortified soya drinks.
• Proteins – foods such as beans, pulses, fish, eggs, nuts, and meat are good sources of protein, vitamins and minerals, so it is important to eat some foods from this group, other vegetable-based sources of protein include tofu, bean curd and mycoprotein. However, some types of meat are high in fat, particularly saturated fat and processed meat including sausages, bacon, cured meats and reformed meat products are not healthy options so should be kept to a minimum.
• Fats – these are important compounds that help the body to absorb key vitamins and minerals, they are also an important energy source. Unsaturated fats are important because they provide essential fatty acids the body can’t make and are found in foods such as nuts, seeds, fatty fish, and rapeseed oil, olive oil and some vegetable oils. Saturated fat such as those found in butter, cheese, red meat, and coconut and palm oils, should be kept to a minimum and wherever possible swapped to unsaturated fats to help to reduce cholesterol in the blood.
• Hydration – the government recommends children aim for 6 – 8 glasses of fluid per day. This includes water, lower-fat milk, and sugar-free drinks such as tea and coffee. Sugary drinks are not recommended, and fruit juices and smoothies can be included in small amounts, up to 150ml daily.

The government also recommends that foods high in fat, salt and sugars such as chocolate, cakes, biscuits, full-sugar soft drinks, butter and ice-cream should only be consumed infrequently and in small amounts.

The government have also published guidelines and menu suggestions for early years settings that parents / carers may find helpful.

The Scientific Advisory Committee on Nutrition (SACN) provides independent advice on nutrition and related health matters to the Office for Health Improvement and Disparities and other UK government organisations. They have produced detailed reports “Feeding young children aged 1 to 5 years” and “Feeding in the first year of life” to help inform government policy and guidelines.

What are the nutritional requirements for children?

Humans whatever their age or gender require the same set of essential nutrients however the amount needed depends on a number of factors including:

• Age
• Body size
• Gender
• Growth
• Health status
• Physical activity
• Certain behaviours
• Certain medications
• Certain genetic traits

Government recommendations for energy and nutrients requirements for children aged 1 – 19 years have been published by Public Health England and can be accessed here. The key nutrients that all children need to ensure healthy growth and developments include:

• Carbohydrates – these are the main source of energy and are found in foods such as fruits, vegetables, bread, rice, and pasta
• Proteins – these help to build muscles and bones and are essential for growth, repair, and energy production, protein is found in foods such as lean meat, fish, poultry, tofu, dairy products, legumes, nuts, eggs, seeds, beans
• Fats – these are needed for brain development and energy, support cell function, and helps the body absorb fat-soluble vitamins. Healthy fats are found in foods such as oily fish, nuts, flax seeds, chia seeds, soybeans, avocados, olives and vegetable oils.
• Calcium – this builds strong bones and teeth and is found in foods such as milk, cheese, yogurt, and green leafy vegetables
• Fibre – this helps with digestion, lowers blood sugar, manages constipation, and boosts heart health. Fibre is found in foods such as fruits, vegetables, wholegrains, nuts, and seeds
• Iron – this is important in making red blood cells, which carry oxygen around the body and is found in foods such as red meat, poultry, fish, eggs, beans, lentils, fortified cereals, dark green leafy vegetables, dried fruits, and nuts
• Zinc – this is an essential nutrient that plays a key role in skin health, immune function, and cell growth and may protect against acne, inflammation, and other conditions. It aids in metabolism, digestion, nerve function, and many other processes. Foods that are highest in zinc include fish and shellfish, meat and poultry, vegetables, particularly mushrooms, kale, peas, and asparagus, eggs and dairy products
• Iodine – this helps to make thyroid hormones, which help keep cells and the metabolic rate healthy. Breast milk contains iodine and is also found mainly in animal protein foods, fish and seafood, sea vegetables, and fortified foods such as bread, cereals, and milk.
• Vitamin A – this is important for vision, skin health, and the immune system and is found in foods such as carrots, sweet potatoes, dark green vegetables, and dairy products
• B group vitamins – these help the release of energy from food and are important as children are so active. These are generally obtained through a balanced diet containing foods such as meat, poultry, fish, eggs, dairy products, leafy greens, and fortified foods.
• Vitamin C – this is crucial for collagen formation, immune system function, wound healing and iron absorption, and is found in foods such as citrus fruits, berries and other fruits and vegetables
• Vitamin D – this is vital for calcium absorption and for developing and maintaining healthy bones, teeth, and muscles. It is produced by the body through sun exposure and is found in certain foods such as fatty fish, red meat and liver, egg yolks, and fortified foods such as some fat spreads and breakfast cereals. The NHS also recommends vitamin D supplements for some children as sunlight can be limited in the UK

According to healthcare professionals, during the first 1,000 days that is from pregnancy to a child’s second birthday, nutrition is especially critical. For the first six months of a child’s life, the World Health Organization (WHO) recommends exclusively breastfeeding as it provides all the energy and nutrients infants need and offers a solid foundation for optimal growth, development and health. If a mother cannot breastfeed, infant formula is the primary and recommended alternative.

There is a wide range of brands and types of formula available in pharmacies and shops. All infant formula on the UK market must meet compositional regulations, so all products are perfectly safe to feed a baby and provides essential nutrients for baby’s growth and development, including protein, carbohydrates, fats, vitamins, and minerals.

At around 6 months of age to meet a baby’s increasing nutritional and developmental needs, solids should be introduced to a baby’s diet. As a baby is gradually weaned from the breast or bottle and new solids are introduced, foods that are rich in iron and zinc, such as iron-enriched infant cereals, pureed meats and poultry dishes are important as are fruits and vegetables for vitamin and mineral content.

Toddlers and pre-school children grow and develop quickly so need a balanced diet that includes starchy foods, fruits and vegetables, dairy, and protein sources. Children at this age should be offered food in the right proportions from the main food groups, however some children may be reluctant to eat new foods or refuse to eat certain foods from time to time. This stage is fairly normal and the best approach is to offer food in a relaxed way making meal times fun, and eating with the child wherever possible as children are more likely to eat foods that they see others eating and enjoying.

If the child goes to a nursery, a childminder or preschool, there are guidelines that providers should follow to make sure that portion sizes, as well as food quality and nutritional content is appropriate.

Nutritional requirements for school children

Food served in all maintained schools and academies in England must meet school food standards so that children have healthy, balanced diets. They severely restrict foods high in fat, salt and sugar, as well as low quality reformed or reconstituted foods. These standards make sure that school lunches always include:

• One or more portions of fruit and vegetables every day
• One or more portions of starchy food, such as bread or pasta every day
• A portion of food containing milk or dairy every day
• A portion of meat or poultry on 3 or more days each week
• Oily fish once or more every 3 weeks

At this stage in a child’s life energy demands are high, due to rapid growth and high levels of physical activity. 50% of a school age child’s daily energy requirements should come from carbohydrates and no more than 5% of carbohydrate intake should be from sugary carbohydrates. Starchy carbohydrates such as those from pasta, rice, wholegrain bread or potatoes should be the main source of energy for children as they release energy slowly over a long period of time. If a child doesn’t get enough carbohydrates, they may feel fatigued, irritable, and have an overall lack of energy. They may also experience growth problems as carbohydrates provide the body with the largest and easiest-to-use form of energy.

A nutrient-rich diet plays an important role in school age children’s mental and physical development and a vital role in maintaining a healthy weight. Eating patterns established at this stage often continue into adulthood, so the more healthy choices children are offered, the better. Despite understanding its importance, ensuring school age children get the right nutrition can be challenging for any number of reasons including budget constraints, busy schedules, picky eating habits, and as children get older and become more independent they may decide to follow particular diets or to restrict certain food groups.

Unnecessarily restricting particular food groups may result in nutrient deficiencies which can be detrimental to health as the child may be missing vital nutrients for growth and development, so it is important to encourage a balanced diet and to educate children on the importance of healthy eating.

Helping your child get enough iron

Iron is an important mineral in a child’s diet. It is needed to make red blood cells which carry oxygen around the body. It also plays an important role in brain development, in fighting infections and for growth. Low iron is most commonly due to insufficient amounts of iron in the diet and if the level of iron stores in the body falls anaemia may result. At first, children with iron – deficiency anaemia may not have any symptoms. When symptoms do happen, a child might:

• Look pale
• Seem moody
• Be very tired
• Get tired quickly from exercise
• Feel dizzy or lightheaded
• Have a fast heartbeat
• Have developmental delays and behavioural problems
• Want to eat ice or non-food items

There are two types of iron found in foods. The iron in meat, chicken and fish which is known as haem iron, and is better absorbed than the non – haem iron from plant sources, although vitamin C from vegetables, fruit or fruit juice can help non – haem iron to be better absorbed into the body. Drinking milk, tea or coffee with meals can reduce the absorption of iron from foods so these should be avoided. Also avoid calcium-rich foods or supplements being consumed at the same time as iron-rich meals as although calcium is essential for bone health, it can compete with iron for absorption.

By focusing on a diverse and balanced diet rich in iron and vitamin C, can help a child meet their iron needs and prevent iron deficiency. Include iron-rich foods in the family’s diet, good sources of iron include:

• Red meats such as beef, lamb and pork
• Offal meats such as liver and kidney. Liver is a good source of iron but should be limited to once per week because it contains high amounts of vitamin A
• Chicken or turkey, particularly dark meat from legs and thighs
• Fish, oily fish is best such as salmon, mackerel, sardines and shellfish
• Pate or fish paste
• Iron-fortified breakfast cereals
• Wholemeal / wholegrain breads and cereals
• Dried peas, beans and legumes such as lentils, baked beans, soybeans, kidney beans and tofu
• Leafy green vegetables such as spinach, kale, broccoli, watercress
• Eggs, mainly in the yolk
• Dried fruit such as apricots and figs
• Peanut butter and nuts. Whole nuts are not recommended for children under five because of the choking risk
• Ovaltine, Horlicks or similar fortified drinks
• Hummus and tahini

Meeting a child’s iron needs is key to their growth and well-being, and there are many ways to include the iron-rich foods listed above into a child’s diet. Ensure that you balance haem and non – haem food sources, adding foods rich in vitamin C, and being mindful of a child’s calcium intake when consuming iron-rich foods.

How to maintain a healthy diet for children

Children’s diets should contain foods from a variety of food groups so that they get the range of nutrients that are needed for their growth, development and general physical and mental health. It is also important to have regular mealtimes so that children become used to eating at certain times of the day from an early age, healthy eating habits and structure formed in the early years often stay with children for life. You should try to provide children with three meals per day and limit snacking to two small snacks in between.

Breakfast is an important meal for children as it supports their energy stores for morning activities. Children who eat a good, nutritious breakfast have been shown to concentrate better, positively affecting learning in children in terms of behaviour, cognitive, and school performance. A breakfast based on carbohydrates (starchy foods) will help with concentration at school. Try to choose cereals that are low in fat, sugar and salt and avoid adding sugar to cereal.

Cereals that contain wholegrains such as porridge, whole wheat cereal biscuits or shredded wholegrain pillows are recommended as these are high in fibre so will help a child to stay fuller for longer. Having milk or yogurt on cereal adds calcium to help with bones and teeth. High protein, low fat cooked breakfasts such as such as poached, boiled or scrambled eggs or baked beans are another healthy option. Choose wholemeal, granary or brown bread for toast as this is high in fibre but avoid sugary toppings such as jam.

School meals are a great choice for lunch as they are required to conform to the government’s nutritional recommendations. However, many children opt for packed school lunches. Healthy packed lunches should include all the food groups, so pack a lunch that includes fruits and vegetables, whole grains, healthy fats, and lean meat, fish or plant-based protein. These will give a child the energy to power through the afternoon, and keep them going until dinner. When not at school it is important that a child still has a nutritious lunch in the middle of the day as it is an opportunity to refuel with healthy and nutritious food.

For evening meals it is important to opt for lighter meals that are easily digestible to avoid discomfort and indigestion before bedtime. Incorporating whole grains, lean proteins, and plenty of vegetables into a child’s dinner can provide all their essential nutrients.

Snacks are an opportunity to offer additional nutrients during the day where food at mealtimes may not meet all of a child’s energy needs. Fruit or vegetable slices, home-made plain popcorn, or dairy foods such as cheese or plain yoghurt with added fruit are examples of nutritious healthy snacks. However, it is not a good idea for children to graze on snacks throughout the day as this may blunt their appetite at meal times. Biscuits, cakes, crisps etc. should be limited for special occasions.

Squash or fizzy drinks are unlikely to provide many nutrients but do often provide too many calories. Children should be encouraged to drink water and limit soft drinks for special occasions.

What types of food should children eat?

Studies have shown that children in the UK typically consume foods high in saturated fat and sugar and low in fibre, their diets contain fewer fruits and vegetables than the recommended ‘5-a-day’ requirement and often contain ultra-processed foods (UPFs). These are items that are heavily processed during their making, such as frozen pizzas, fizzy or milk-based drinks, mass-produced packaged bread and many ready meals. In the UK, children consume the highest levels of ultra-processed foods in Europe and have the 8th highest levels of obesity among 10 – 19-year-olds.

Cooking food from scratch is one of the best ways to control what foods children are eating. It is really important to have a healthy diet that includes fruits and vegetables, complex carbohydrates, lean protein and dairy foods. Cooking from scratch doesn’t need to be complicated. It is about using unprocessed ingredients and simple recipes, making it a straightforward way to enjoy healthier, more satisfying meals. Cooking from scratch allows you to control the ingredients and create healthier meals that are tailored to the child’s needs and preferences.

All children need:

• At least 5 different fruits and vegetables each day this includes all fresh, frozen, tinned and dried types
• Potatoes, bread, rice, pasta or other starchy carbohydrates incorporated into each meal and as some healthy snacks, these should make up a third of the food served each day
• Beans, pulses, fish, eggs, meat and other proteins or vegetarian alternatives in at least 2 meals
• Dairy foods and alternatives for 2 – 3 meals and for snacks each day

The focus of healthy nutritious eating for children should always be on providing a range of interesting and tasty foods that can make up a healthy diet, rather than a focus on denying them certain foods and drinks.