Yesterday Mrs Jones recorded Jessica’s food diary:
| Time | Food |
|---|---|
| 6.00am | 150ml milk in bottle |
| Breakfast | half-cup (1/2) breakfast cereal with milk banana 1 slice of toast with margarine |
| During morning | 30g chocolate bar half slice cheese 200ml fruit juice drink in bottle 2 plain sweet biscuits |
| Lunch | half peanut butter sandwich 200ml flavoured milk in bottle |
| Afternoon | small bag potato crisps 150ml milk in bottle |
| 7.00pm | Refused meat and vegetables Refused custard |
| Before bed | 150ml milk in bottle 2 plain sweet biscuit |
Question 01: Which food should be reduced in Jessica’s diet? |
|---|
| Peanut butter sandwich |
| Toast with Margarine |
| Cereal with milk |
| Cheese |
| Crisps |
| Check answer |
ExplanationEnergy intake - Now that Jessica is well she will eat enough food for her needs. Mum needs to concentrate more on the types of food offered, and the balance of the diet. |
The Australian Dietary Guidelines for Children and Adolescents in Australia includes an outline of the balance of food groups needed for children aged 4 to 7. While Jessica is younger than this, we can use it as a guide to compare Jessica’s food diary with the recommended food groups:
Australian Dietary Guidelines for Children and Adolescents in Australia
| Foodgroup | Jessica’s intake | Min.serves 4-7 yrs |
|---|---|---|
| Bread ,cereals, rice, pasta , noodles | 1 serve of bread
½ serve cereal Sweet biscuits fit into the extra foods category |
5-7 |
| Vegetables | None Potato crisps fit into the extra foods category |
2 serves |
| Fruit | ½ serve | 1 |
| Milk, yogurt and cheese | 750 ml milk + ½ slice of cheese = 3 serves | 2 serves |
| Lean meat, fish. poultry, nuts legumes | none | 1/2 serve |
| Extra foods | Chocolate
Biscuits Chips /crisps, Sugared breakfast cereal Fruit juice drink |
1-2 serves |
Jessica is filling up on excessive amounts of less healthy foods to the detriment of healthier choices. When nutrient intake is calculated, this intake meets her energy needs but is low in iron, zinc, thiamin and fibre. Research has shown that the total energy intake of a toddler is remarkably consistent over 24 hours, although very variable from meal to meal and from toddler to toddler.
Jessica is meeting her energy needs early in the day from snacks and to some extent milk, so refuses dinner.
Jessica’s mother needs to offer the extra foods less frequently and replace these with fruit, vegetables or plain crackers. One drink of milk and the fruit juice drink could be replaced with water, and she should be changed from a bottle to a cup. Excess milk and fruit juice are a common cause of poor solid intake in children. Serving dinner earlier when Jessica is hungrier is more likely to be successful. Reducing extra foods will also reduce the saturated fat in Jessica’s diet. She could be changed to a reduced fat milk at her age but this is not the nutritional priority of the other messages.
Growth charts: www.cdc.gov/growthcharts/
The Australian Guide to Healthy Eating: www.health.gov.au/internet/main/publishing.nsf/Content/phd-gug-child-familybook
NHMRC Recommended Dietary Intakes for Use in Australia: www.nhmrc.gov.au/publications/synopses/n6syn.htm
Australian Government Department of Health and Aging
Thompson S, A healthy Start for Kids. Simon and Schuster, Sydney, Australia, 1995
This book is a very readable handbook written for lay people, which provides lots of practical advice and information.
Mc Veagh P, Reed E. Kids Food Health. Finch Publishing Co, Sydney, Australia, 2001.
Sensible, practical and enjoyable to read, these books provide a guide for parents to establish healthy eating habits in their children that will carry into adulthood.
Shaw S, Lawson M, Clinical Paediatric Dietetics. Blackwell, Oxford, England, 2001 2nd edition
This is a standard paediatric dietetics textbook, in which the first chapter gives some relevant basic facts and figures.
Thompson S, A healthy start for kids: building good eating patterns for life. Simon and Schuster, Sydney, Australia, 1995
opac.library.usyd.edu.au/record=b2030640~S4
Mc Veagh P, Reed E. Kids food health: nutrition and your child's development
Finch Publishing Co, Sydney, Australia, 2001.
opac.library.usyd.edu.au/record=b2550667~S4
Shaw S, Lawson M, Clinical Paediatric Dietetics. Blackwell, Oxford, England, 2001 2nd edition
opac.library.usyd.edu.au/record=b2437700~S4
3rd edition available in Scitech library.