Nutrition In Child Care - CareforKids.com.au®

Nutrition In Child Care
How do services best provide nutritious and enjoyable food for children?

This article on childhood nutrition in child care services has been provided by registered nutritionist Leanne Cooper. Leanne is the Director of Cadence Health and a childhood nutrition spokesperson and advisor.

In Australia some state governments provide only broad statements regarding child care legislation relating to nutrition. For example, Queensland centres are required to provide 'adequate and nutritious food' for children in their care. Exactly how you should do this isn't stated, though the upside I suppose is the degree of flexibility afforded by these guidelines.

New South Wales and Victoria however require centres to provide at least 50% of recommended dietary intake (RDI) of nutrients; Western Australian centres are required to provide 50-67% of RDI of all nutrients; and South Australian centres are required to provide 67% of daily food requirements (Radcliff et al, 2002). The findings vary on how well centres meet these requirements, with some showing that the dietary guidelines are being met and others finding that they are not.

Ideally children require around 50% of their daily nutritional needs to be met during their time in care, though this tends to apply more to long day care. However, there are some issues that make this a little tricky:

Having a nutritionist on staff is extremely rare, and the only way a provider is likely to have access to such services is via parental support.
Each child will differ in their needs and if you are to provide the number one dietary guideline: Variety, then assessing a large variety of meals would be costly and time consuming.
What each child eats both in care and at home will change what their actual nutritional needs are.

To expect a centre to number crunch its meals is not only unrealistic but illogical: So how do centres best provide nutritious and enjoyable food for their children?

Let's take a look at a few tips that might simplify this process and make it achievable.

CREATING NUTRIENT DENSE MEALS

Variety is the key!
Above all else if you were to focus on providing a variety of healthy foods then your centre will go a long way to covering a wider base of nutrients and reducing potentially unwanted compounds.

Easy ways to ensure variety are by choosing various coloured fruit and vegetables, offer two or more food groups in a meal and so on. For example cheese with fruit.

Simple assessment
Food serving guides are the easiest guides for assessing meal quality. Review the Food For Health, Dietary Guidelines for Australians, a guide to healthy eating by the National Health and Medical Research Council for more details on what constitutes a serving and how many are needed per day, copies of booklets and posters are free.

It is quite simple to create a chart using the food groups as headings, and then simply tick off food groups provided in each week’s menus. This is a simple, cost effective and useful way of checking that you are offering the correct number of servings of each food group.

Whole foods offer more
Another simple way to increase the nutritional status of meals is to offer quality food, i.e. whole foods as opposed to processed foods. Now this may sound obvious, but keep in mind, for example, if you use soy milk in the centre that there are two basic types. Soy milk can be made from soy-protein isolates (bits of soy) or whole soy beans. The former tends to come with a much longer list of ingredients to make it more palatable, and the latter potentially has more of the plant compounds intact. Plus they taste quite different!

The same applies to yoghurt, you can buy thickened milk products, most now with some good bacteria added in at the end, or naturally fermented yoghurt made from healthy bacteria. Again the ingredients lists look quite different and the health benefits are miles apart.

Try and select foods closest to their natural state, wholegrains, brown rice, unprocessed options and so on. Such foods come packed with a more impressive array of health compounds and nutrients.

Fabulous fish is brain food
Fish containing those renowned omega-3 fish oils have been shown to assist brain development, they may also be beneficial in managing inflammatory illnesses, allergies and ADHD. A simply way to get fish oils into a diet is by using tinned fish, Choice found that tinned salmon (tinned tuna isn't as rich in omega-3s) has good levels of omega-3's and it is cost effective, safe, clean and healthy.

How much fish is too much fish?
Children up to the age of six years should eat 2-3 serves a week of fish (1 serve is 75g). However, to avoid a build up of mercury they should have only 1 serve of Orange Roughy or Catfish a week, and only 1 serve per fortnight of Shark (Flake) or Billfish (Swordfish and Marlin).

Nutrients under the microscope
There are an increasing number of nutrients that have been found to be potentially deficient in the diets of Australian and New Zealand children: notably iodine and vitamin D (particularly in dark skinned and veiled children). It's a good idea to check that foods rich in these nutrients are represented in your menus.

However, sodium is a poorly understood nutrient in terms of labelling. Sodium doesn't have an RDI it has an adequate intake (AI) and a UL or upper limit because it is assumed we are at greater risk of excess than deficiency. A child aged 1-3 years has an AI of 200-400mgd with an UL of 1,000mgd. Just a cheese and vegemite sandwich can get children very near this UL, with each ingredient generally being excessive in sodium; you would be surprised at just how much sodium now goes into our foods, sadly.

Encourage staff to become familiar with labels! Opt for products that are salt-reduced, watch the use of high sodium foods. Products with 120mg or less per 100g are considered low-sodium, though you will be hard pressed to find these products.

HEALTHY HABITS

Water is best
Water is by far the best drink for children. While milk is of course a great source of calcium and protein, too much isn't a good thing. Excessive milk can interfere with iron uptake and also appetite. Generally for children consuming other calcium-rich foods just one cup a day is all they need. Low-fat options can be used from two years onward, but, in honesty if you have to have something in a fat-altered version the best message is limit the original product to create a better understanding and balanced diet. Low-fat products are currently under scrutiny in regards to just how effective they are in managing weight issues.

Don't forget if your centre is required to offer dairy alternatives to ensure they are calcium-enriched (100mg per 100g or mls). There is a fabulous range of soy, rice and oat milks that are all calcium fortified.

An interesting point that many people aren't aware of is that apple and pear juice causes a mal-absorption in children's intestinal canals, leading to diarrhoea. In extreme cases it can be related to failure to thrive. Given the predominance of apple juice as a drink and its presence in children's food products as a sweetener this is a good tip to share with parents. If juice is offered it should be diluted down to ¼ and no more than 150mls a day (see table below).

Recommended maximum fruit juice intake per day

1 – 6 years	150 mls
7 – 18 years	240 – 360 mls (over two servings)

Source: NHMRC, Dietary Guidelines for Children and Adolescents

FRUIT JUICE FACTS FOR PARENTS AND CARERS

It takes about four pieces of fruit to make one glass of juice. So it isn’t surprising that even a small juice can make your child feel full and less inclined to eat a meal (see also Figure 1).
Excessive intake of juices (and milk) provides a great deal of calories from sugars and can displace nutrients. This could compromise the variety and total nutrients (and fibre) that your child consumes over the course of the day. This may explain why your child hardly seems to eat but will gulp down milk by the bottle.
Too much apple or pear juice can also lead to severe diarrhoea.
Some drinks can contribute to dental cavities.
Too much fruit juice (more than 350ml/day) may be linked to obesity in toddlers.
Excessive intake of juices has been associated with failure to thrive (NHMRC, 2003)

Watch the vegetarians
Vegetarian children should eat at least two protein-containing foods in each main meal to ensure they consume all the essential amino acids they need for growth, development and immunity. It is also important that they eat a good variety of plant foods as well as eggs and dairy to gain iron, zinc, B12 and other essential nutrients. Vegan diets are not suitable for children.

Protein can reduce hunger
Did you know that protein is the nutrient that tells our brains we are full? A quick and easy way to make sure children, vegetarian or not gain enough protein is to give them a palm-sized serve (their palm) of a protein food in each main meal.

TIPS FOR CHOOSING THE BEST PRODUCTS

Use the labels
Here's a handy tip for your staff member who purchases/orders products. The two most helpful pieces of information on a food label are the 100g column and the ingredients panel. Not only can this information tell you what is used in the product, but roughly how much, and how it compares to similar products.

Ingredients are listed in greatest quantity to least. So if you are looking at a tomato based pasta sauce. Product A lists ‘water, tomatoes, sugar, carrots, capsicum and salt’ and Product B ‘tomatoes, water, capsicum, carrots and salt’, you can see that product B has no added sugar and is likely to have more vegetables by weight.

The other area to look at is the 100g column, by using this column you can compare like with like. Comparing servings of one product to another can be redundant as serving sizes often differ between products. In addition you can see how products compare on things such as protein and fat.

Even more interesting is the carbohydrates and sugars figures: The carbohydrate figure represents all the sugars, fibre and carbohydrates in that product. The sugars figure represents all the naturally occurring and added sugar (which is the bad guy here). Ideally you should purchase the product that has a lower ratio of sugars to carbohydrates. For example, if you compare a breakfast cereal that contains dried fruit you will note a much higher sugar figure than say a cereal that is just wholegrain biscuits.

Using both the ingredients label and carbohydrates figures can significantly reduce the amount of added sugars on your menu. Stay tuned on this point, as we are likely to see a shift of focus from fat to sugars in regards to weight issues.

For more information or to purchase one of Leanne's Child Care Centre Nutrition Kits go to CadenceHealth.com.au. For free children's nutrition tip sheets go to sneakys.com.au