Just as adults do, children have specific nutrient requirements set through the Dietary Reference Intakes (DRIs) and Accepted Macronutrient Distribution Ranges (AMDRs), as well as recommendations for food choice through the U.S. Dietary Guidelines for Americans and MyPlate.

After one year of age, children learn to feed themselves and consume new and different foods. Although their growth is slower than it was during infancy, it continues steadily through the toddler and preschool years and in periodic “spurts” during the elementary school years and early adolescence. Some parents get concerned because their children’s interest in food declines during periods of slower growth, but the trend usually reverses itself during accelerated growth periods. Energy requirements in children, as in adults, are based on age, sex, and activity level. (INFOGRAPHIC 18.5)

Question 18.3

Children of all ages need adequate amounts of all essential vitamins and minerals, so it’s important that they eat varied and balanced diets that emphasize nutrient-dense foods. Although children’s nutrient needs are generally lower than those of adults (because of their smaller size), they are no less vital to optimal growth, development, and health. Recommended nutrient intakes do not differ for boys and girls until about age nine years, when maturation and sexual development influence dietary needs. By adolescence, micronutrient needs are similar to those in adulthood.

According to the AMDRs set by the Institute of Medicine (IOM), carbohydrates should be children’s primary source of energy, composing 45% to 65% of total calories (the same range recommended for adults). Children need sufficient protein, too—for growth, tissue maintenance and repair, and other essential functions. For children aged 1 to 3 years, protein should make up 5% to 20% of total calories, and fat should make up 30% to 40% of their total calories. (INFOGRAPHIC 18.6) For older children aged 4 to 18 years, protein should compose 10% to 30% of total calories, and fat should make up 25% to 35% of total calories. These amounts reflect the transition from the higher fat intakes of infancy to the lower recommended fat intakes of adulthood. They also account for the fact that diets too low in fat may not provide sufficient intake of essential fatty acids as well as certain vitamins. Dietary fat also provides energy, which may be particularly important for younger children during the transition from a primarily breast milk or formula-based diet to a mixed diet.

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Question 18.4

The U.S. Dietary Guidelines for Americans also provide dietary recommendations for the general public 2 years and older, focusing on three main areas of emphasis. The first is the importance of balancing calories with physical activity to manage weight. The second is that individuals should eat more vegetables, whole grains, fat-free and low-fat dairy products, and seafood. The third is that individuals should consume fewer foods high in sodium, saturated fats, trans fats, cholesterol, added sugars, and refined grains.

http://www.choosemyplate.gov/ offers daily food plans and science-based advice, too, to help kids and their parents build healthy meals and maintain or reach a healthy weight. Among other things, MyPlate can guide children toward age-appropriate portion sizes. For children up to age 8 years, for instance, one tablespoon per year of age is considered an appropriate serving size for many foods—so it might be appropriate to give a 3-year-old three tablespoons of mashed potatoes rather than an adult serving of ¹⁄₂ cup or more. (INFOGRAPHIC 18.7)

Question 18.5

Parents also play an important role in shaping their children’s eating behaviors by establishing the eating environment and modeling food-related behaviors and attitudes. Decades of research have consistently shown that children’s eating patterns are strongly influenced by their physical and social environment—and the factors that influence this environment, such as parental education, time constraints, and ethnicity—and kids, like adults, are likely to eat foods that are available and easily accessible.

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Young children especially depend on their parents to provide appropriate nourishment, so early parental influences can play an important role in determining a child’s relationship with food later in life. As children grow older, they take more responsibility for feeding themselves and making decisions about food choices, but their tendencies are still strongly shaped by parental influence. For instance, parents can affect children’s dietary practices by determining what foods are offered and when, the timing and location of meals, and the environment in which they are provided. They model food choice and intake and socialization practices surrounding food. Also, how parents interact with their children in relation to eating during mealtimes can influence how children relate to food in general, which can have an impact not only on nutritional choices but also on lifelong food preferences and eating habits. Studies demonstrate that although specific parenting styles are not strongly linked to negative eating behaviors and nutrient-poor food choices, a balance between parental authority and permissiveness within an appropriate eating environment helps guide children toward making healthier choices on their own as personal responsibility and independence increase.

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To encourage healthy eating habits, parents should provide their kids with a variety of nutritious foods and encourage—but not force or bribe—their children to taste them. Food preferences are in large part learned through repeated exposure. The more a parent offers a food, the more likely a child will accept and try it; and the more a child tries it, the more likely he or she is to like it. Studies suggest that children may need to try a new food at least 10 times before they develop a taste for it. Involving children in food shopping and meal preparation also helps to expose them to different foods, educate them about nutrition, and engage them in the process of feeding the family. Ultimately, nutritionists suggest that parents should consider themselves responsible for the quality (type) of food and the frequency of feeding (when food is offered), but children as young as age two years should be permitted to gauge the quantity they consume. Serving children adult-size portions or forcing them to “clean” their plates can result in excess intake and make it difficult for children to determine when they have had enough to satisfy their hunger and avoid habitual overeating.

Sometimes, children develop particular ways of eating—they might only eat sandwiches if they’re cut into triangles, for instance, or they will only eat one food item meal after meal. These behaviors, called food jags, are developmentally “normal” as children strive for more independence and control. Kids generally outgrow them with patience and guidance.

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In addition to a varied and balanced diet, children should also engage in regular physical activity. Yet research suggests that less than half of all U.S. children meet the physical activity guidelines set by the U.S. Dietary Guidelines for Americans. These recommend that children and adolescents older than six years participate in 60 minutes or more of developmentally appropriate and enjoyable physical activity per day. Younger children should play actively several times a day. It’s fine for kids to be active for short bursts of time rather than sustained periods, as long as these bursts add up to meet recommendations.

Unfortunately, children who don’t meet the guidelines also tend to have lower diet quality—they eat fewer fruits and vegetables and more energy-dense snacks, drinks, and fast foods—which compounds their risk of obesity and chronic disease.