Updated March 29, 2022 / By Leah Alexander , M.D., F.A.A.P.
Good nutrition is an essential component of having a healthy mind and body. A healthy diet is not only important during infancy, but throughout childhood and adolescence. Fruits, vegetables, proteins and high fiber carbohydrates provide vitamins, minerals, energy, and the “building blocks” for growth. Diets that are low in nutritional value can affect weight gain and ultimate height as well as impair cognitive development.
The quality of the foods consumed during childhood can also have longterm effects. For example, the sugary foods and beverages that most kids love promote tooth decay, obesity, and elevated cholesterol levels. Recent studies have also revealed a link between sugar intake and a type of wheat intolerance called celiac disease.
In addition, excessive amounts of sodium increase the likelihood of developing heart or kidney disease later in life. Because of this risk, the FDA has issued new guidelines for food manufacturers and the restaurant industry, urging them to reduce the amount of salt in their products. After age two, regular consumption of high fat foods increases the risk of type II diabetes, heart disease, and some types of cancer.
In an effort to help parents understand exactly what foods kids should eat, the USDA has created MyPlate. Let’s further discuss the nutritional needs of each age group.
According to the World Health Organization, breastmilk provides all of the nutrients an infant needs during the first six months of life. It has the perfect blend of fats, protein, carbohydrates, and immune support. When breastfeeding is not possible, an infant formula is the next best option. Most infant formulas on the market are cow’s milk based. In situations where this type of formula is not tolerated or a plant-based option is preferred, soy-based formula is an option.
Either breastmilk or formula should be given to infants until their first birthday. Whole cow’s milk is inappropriate because the amount of sodium and potassium is too high for a baby’s kidneys to process. It also lacks iron, so babies may develop anemia. Iron is an essential mineral because it is promotes healthy red blood cells and brain development.
Between the ages of four to six months, first foods may be introduced to provide additional nutrients to support growth. Infants with good head support and torso muscle strength should be able to sit in a high chair for spoon feedings.
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The recommendations of which foods to offer first has changed over the years. Any soft, pureed food may be offered at this age. Withholding foods that are commonly associated with allergies, such as nuts, fish, and eggs, is no longer necessary. Infant rice cereal should be avoided, however, due to contamination with arsenic, a poison that can cause cancer and other illnesses.
Single foods should be offered one at a time, for three to five days, in case of an allergic reaction. Once a variety of single foods have been tried and tolerated, food mixtures are safe to give.
Because dietary fat assists nerve connectivity and brain development, full fat dairy products, egg yolks, and other fatty foods are encouraged for infants. Parents should be mindful of the choking risk of chunkier textures, and reserve these for older infants or toddlers.
Note: Unpasteurized foods and honey should be avoided due to the risk of botulism and other life threatening bacterial illnesses.
Many two to five year olds begin to refuse foods that were once loved. Some toddlers won’t eat food with a green color which excludes many healthy vegetables. Others suddenly dislike the textures of meat and poultry as they take “too much effort to chew.” These types of eating behaviors are normal and expected during the toddler years. While it can make mealtimes more challenging, parents should continue to offer items from all food groups.
Limited diets can be low in iron and zinc which can cause anemia and poor growth. Food sources of these minerals include fish, legumes, nuts, eggs, poultry, and meats. Ground versions of meats, chicken and turkey are often more readily accepted by toddlers.
It is necessary to continue offering fruits and vegetables instead of juice which provide vitamins and fiber. When toddlers drink too much of a high sugar beverage, it suppresses their appetite, causes tooth decay, and fosters a preference for sweeter foods.
Water and milk are the preferred beverages. Under the age of two, the higher fat content of whole milk or soy milk are recommended for the brain development and eye health benefits. Over the age of three, lower fat versions promote better heart health, and reduce the risk of obesity. However, excessive milk intake can be problematic. Drinking more than 24 ounces of milk daily can cause constipation and iron deficiency anemia. It can also make small toddler bellies feel “too full” at mealtime. Keeping the diet balanced is important not only for better health, but also to further expand a toddler’s palate.
Note: Certain foods are choking hazards under the age of five. Any round-shaped food that is the size of a cherry or smaller should be cut into quarters to prevent it from accidentally lodging into the airway. Casings should be removed from sausages-type meats. Toddlers should always be supervised while eating foods with pieces that may break off, and popcorn and chewing gum should be avoided.
Grade school children have unique nutritional needs. Many kids engage in sports or other physical activities, and the caloric needs change. A healthy diet is important to support muscle mass and growth, but also for optimal brain function in school.
The vitamins and minerals obtained from fruits, vegetables, and proteins are still important. Unfortunately, less than five percent of six to 12 year olds eat the recommended two cups of vegetables per day, and fruit juice is often preferred over whole fruit. Foods that are high in calcium support bones during the prepubertal growth spurt. Fortified cow’s milk provides vitamin D which helps with calcium absorption.
In contrast, sugary and high fat foods are low in nutritional value, and can lead to unhealthy weight gain and elevated cholesterol levels. According to the American Academy of Pediatrics, 40 percent of children and adolescents are overweight. Preventing obesity by offering more nutrient dense foods promotes better health during childhood and in the future.
Many physical and metabolic changes occur between the ages of 13 to 18. The quality of foods eaten during these years can also affect future health. Body image issues and interest in fad diets often result in poor teen dietary choices. The caloric needs for adolescents who engage in rigorous sports may be higher than those who have a more sedentary lifestyle.
During these final years of physical development, it is important to include foods that contain vitamin D, calcium and protein for overall physical and hormonal health. Foods that contain iron are particularly important for girls who are menstruating. Some develop iron deficiency anemia due to menstrual difficulties, and require supplements. In addition, low dietary iron and folic acid during adolescence may lead to adult pregnancy difficulties.
Despite the nutrient benefits of fruits and vegetables, daily consumption of these essential foods is the lower in teens than in other age groups. Deficiencies in dietary vitamins, minerals, and other nutrients can stunt growth, and cause obesity, type II diabetes, and high cholesterol.
A healthy, balanced diet is important from infancy through adolescence. The variety of nutrients obtained from fruits, vegetables, proteins, and nutrient dense carbohydrates are important for growth and development. Each food group offers specific benefits, so it is best to consume them daily. Low nutrient diets can result in deficiencies that are detrimental to growth, cognitive development, and future health in adulthood.
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