Getting kids to eat is no easy feat, and we’ve all been known to make compromises here and there in the interest of filling bellies. But as the concessions add up, bad habits take shape. Here are some of the most common nutrition issues I see in my practice, and why you should be paying attention.
Trap 1: Pizza as a go-to meal
As the second highest source of calories in kids’ diets today, when it comes to pizza, they may be getting too much of a yummy thing. Pizza has inched into the regular meal rotation for many parents because it’s easy to order or simple to prepare, and it’s a dinner that most kids happily eat. While pizza may contain all of the major food groups (grains, vegetables, dairy, and meat) and tastes delicious, it’s also high in calories, fat and salt. A recent study in Pediatrics reveals that on days kids eat pizza, their overall daily calorie, fat and sodium intake is much higher due to the extra load from pizza. The study’s authors recommend cutting back on what they consider over-consumption of pizza, as well as making pizza more nutritious for kids—for example, making it at home, using whole-grain dough (which can be purchased at many grocery stores and bakeries), keeping the crust thin and loading up on nutritious veggie toppings. Pizza should be a special treat, but when you do order in, keep slices small and veggie sides larger.
Trap 2: Too much salt
Sodium is an important essential nutrient—our bodies need a small amount to function, but many kids consume more than twice the amount they need every day. Chronic excess sodium can establish long-term habits of eating salty foods and impact eventual adult health—it has been linked to high blood pressure and risk of heart disease, kidney issues, stroke, osteoporosis and even asthma in adulthood. Salt-related health problems, such as elevated blood pressure can also sometimes emerge in childhood. The main source of salt for kids is processed food—some estimates peg packaged foods (breads, processed meats, soups, pasta dishes and sauces) at 75 percent of a typical kid’s diet. Health Canada recommends these upper limits for daily sodium intake based on age: 1500 mg/day for kids one to three years; 1900 mg/day for kids four to eight years; and 2200 mg/day for kids nine to 13 years. With a typical kid’s diet, many children will hit their upper limit by the time they’ve finished lunch! The best ways to reduce your kid’s salt intake: cut back on packaged and processed foods, get familiar with brands that offer low-sodium versions and pay attention to labels to ensure overall sodium levels are below upper limits.
Trap 3: Not enough fibre
Fibre is found in all plants (i.e., grains, fruit, vegetables, and beans). Many people don’t realize that fibre is not actually digested in the body, but plays an important role in cleaning out the digestive tract as it passes through the body. Childhood constipation is pretty common, most often cause by too little fibre and fluid—most kids get less than half the fibre they need. Canada’s food guide recommends four to six servings of fruit and veggies a day for kids, and three to six servings of grains. It’s easy to get more fibre into your kid’s diet:
- Replace bread and cereals with high-fibre versions—look for “whole grain”, “bran” or “fibre” in the name.
- Introduce high-fibre side dishes like brown rice, quinoa or barley or add them to soups instead of noodles.
- Add fruit to cereal (choose higher-fibre fruits like raspberries, blueberries, kiwis, pears, apples, mangoes, strawberries, dried apricots, cranberries and raisins).
- Sprinkle a few tablespoons of bran onto yogurt or cereal or add it to muffin, cookie or pancake batter.
- Air-popped popcorn is also a good source of fibre for kids four and older (in younger kids, popcorn could potentially be a choking hazard).
- On packaged foods, look for at least 2g and ideally 4g of fibre per serving.
Trap 4: Juice
Sweetened beverages are one of the major contributors to childhood obesity. Some fruit juices, punches and fruit cocktails may actually contain as much or more sugar than pop. Sweetened fruit juices can load on extra empty calories without filling kids up. Fruit juices should not be used as a replacement for actual fruit, which contains important nutrients, vitamins and fibre. Toddlers who drink too much juice risk developing “toddler’s diarrhea,” which occurs when the high concentration of sugar from juice draws water from the body into the digestive tract, leading to soft runny stool. Instead of juice, offer water throughout the day and encourage kids to drink with their own BPA-free water bottle. If you do offer juice, choose unsweetened, 100% fruit juice and limit it to four ounces (120 mL) or less a day.
Trap 5: Milk mistakes
Did you know that some toddlers get too much milk and that kids don’t need high-fat milk after they turn two years old? Milk (and some milk alternatives) are important bone-building sources of calcium for growing kids and are also enriched with Vitamin D. Canada’s Food Guide recommends two servings (about 500 millilitres) of milk or milk alternatives a day for kids between two and eight years, and three to four servings a day for kids nine to 13 years. Once they turn two, you can offer kids one or two percent milk, while skim milk should not be offered until at least five years of age.
Beyond a year, milk intake should hover around 16 to 24 ounces (500 to 720 millilitres) a day. Too much milk can actually be detrimental to toddlers’ health, filling them up and turning them off of solid foods and the essential nutrients they contain, iron in particular. Toddlers who drink too much milk can become low in iron, which often leads to anemia. To help keep milk intake in check, switch to a sippy or open cup once kids are ready.
Joelene Huber is a paediatrician and assistant professor of paediatrics at the University of Toronto and is affiliated with St. Michael’s Hospital and the Hospital for Sick Children, specializing in development and autism spectrum disorders. She appears regularly on TV and is a mom to two small children. Follow her on Twitter at @DrJoeleneHuber.