Recommended Intake for Children This leaflet is intended for parents or carers of children and contains information on healthy eating and appropriate portion sizes for children and young people. It is a first-line advice sheet which may be issued by doctors, practice nurses, health visitors, school nurses, Change4Life advisors, Children s Centre Staff and dietitians. Introduction Children require a varied and balanced diet to provide energy and nutrients for growth, development and activity. The Eatwell Plate below represents a balanced diet and it is applicable to children over 5 years, adolescents and adults. Guidelines for younger children are also based on this, although the healthy eating principles are less strictly enforced in this age group. A routine is very important. A child should be offered regular meals and snacks, rather than giving food whenever they ask. Eatwell Plate Public Health England in association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland 1
Getting the Balance Right Food Group Foods included Main nutrients supplied Bread, rice, potatoes, pasta and other starchy foods Fruit and vegetables Bread, chapatti, breakfast cereals, rice, couscous, pasta, millet, potatoes, yam and foods made with flour such as pizza bases, buns, pancakes Fresh, frozen, tinned and dried fruits and vegetables, unsweetened fruit juice Carbohydrate B vitamins Fibre Some iron, zinc and calcium Vitamin C Phytochemicals Fibre Carotenes Recommended frequency (see table below and separate sheets for ageappropriate portion sizes) Serve at each meal / snack if required Note: If excessive weight gain is a concern then snacks may need to be limited Offer a variety at each meal Aim for 5 servings per day Note: Fruit juice can be counted as a portion once per day. For under 5 s this should be diluted with at least half water. Milk and dairy foods Breast milk, formula milk, cow s milk, yoghurts, cheese, calcium enriched soya, oat and rice milks, tofu Note: Rice milk is not suitable for children under 5 years Calcium Protein Iodine Riboflavin 3 servings per day. Note: Semi-skimmed milk can be used after 2 years and skimmed milk can be used after 5 years if growth is good. Meat, fish, eggs, beans and other non-dairy sources of protein Meat, fish, eggs, Quorn, pulses, dhal, nuts, seeds Iron Protein Zinc Magnesium B vitamins Vitamin A Omega 3 long chain fatty acids: EPA and DHA from oily fish 2-3 servings per day Fish should ideally be offered twice per week (at least one serving should be oily fish) Note: Vitamin C helps the body absorb iron from foods, so ensure that some fruit or vegetables are included with these foods 2
Food Group Foods included Main nutrients supplied Recommended frequency (see separate sheet for age-appropriate portion sizes) Foods high in fat and/or sugar Butter, margarines, cooking oil Cream, salad oils, mayonnaise, chocolate, confectionary, jam, sugar, syrup, crisps and other high fat savoury snacks Some foods provide: Vitamin D & E, omega 3 fatty acids Small amounts of spreads and unsaturated oil can be given daily, but keep other foods from this group to a minimum. These foods can be a useful source of energy but they only contain small amounts of the other nutrients needed for health. Note: If excessive weight gain is a concern these foods may need to be limited Fluid All drinks including water, milk (see dairy section), squashes, juices and hot drinks Water Fluoride in areas with fluoridated tap water 6-8 drinks per day and more in hot weather or after extra physical activity Note: Sugary drinks should be discouraged from both a healthy eating and dental health aspect. Soft drinks containing artificial sweeteners should be limited to meal times as the acid in them can cause dental erosion. All squash and juice should be well-diluted for under 5 s e.g. 1 part squash to 10 parts water Vitamin and mineral supplements A vitamin A & D supplement is recommended routinely up to 5 years of age from 6months of age in breastfed children or when the child is having less than 500ml formula milk per day. Folic acid is recommended for adolescent girls who could become pregnant. Vitamin D is recommended for pregnant teenagers. 3
Food Groups and Number of Portions per Day see individual age reference sheets for pictures / information re: portion sizes Food Group Age 1-3 years Age 4-6 years Age 7-10 years Age 11-14 years Bread, rice, potatoes, pasta and other starchy foods 6 6 6 7 Fruit and Vegetables 5 5 5 5 Milk and Dairy Foods 3 3 3 3 Meat, fish and other non-dairy sources of protein 2 2 3 3 Fats and sugars 3 3 3 3 4
Portions Although the principles of healthy eating are similar for adults and children, children do not require the same size portions as adults. They have smaller bodies and stomachs and their portions should reflect this. At different ages, children will require different amounts of food to meet changing energy and nutrient requirements. They may eat varying amounts from day-to-day, particularly younger children, but this is normal behaviour and as long as they are having a varied diet and growing well, it is likely that they will be meeting requirements. Tips for controlling portions Be careful of pre-packaged portions. Most processed foods are sold as adult portions so a child will not need the full portion. Try using a smaller plate or bowl for your child. This will make it easier to offer child-size portions. Try to have regular meal and snack times. If a child says they are hungry in between these e.g. whilst you are cooking a meal, try giving them a glass of water rather than an extra snack to keep them going until the mealtime. This will help to fill them up for a short time. It will also stop them overeating and prevent them ruining their appetite for the meal. Give your child less rather than more to start with they can always ask for second helpings. This way you ll have less waste and they won t eat too much. As it takes approximately 20 minutes for the brain to send signals that you are full, it is a good idea to encourage your children to eat slowly as this will allow them to recognise when they are full. Try to have mealtimes without the television switched on. If your child is watching television it can distract them and they may not notice the signals telling them they are full. Never force your child to clear their plate. If they say they re full, they probably are full! Recommended portions The appendices linked with this resource are a rough guide for portion sizes at different ages. They are based on average requirements for a specific age range. If your child is at the younger end of the range you may need to offer slightly smaller portions and similarly if they are at the higher end of the age range, you may need to offer slightly larger portions. Also if your child is underweight or overweight, the portion sizes may need to be increased or reduced accordingly. 5
PALS We offer a Patient Advice Liaison Service (PALS). This is a confidential service for patients and their families to help with any questions or concerns about local health services. You can contact the service by direct telephone line on 01926 600054 or using the phone links which are available in both hospitals or calling in at the office located in the main entrance at Warwick Hospital. Our information for patients can also be made available in other languages, Braille, audio tape, disc or in large print please contact our PALS office. As a key provider of healthcare and as an employer, the Trust has a statutory obligation to promote and respect equality and human rights. This is set out in various pieces of legislation including: Race Relations (Amendment) Act 2000, Disability Discrimination Act (2005), Sex Discrimination Act (1975) and Age Discrimination Act (2006) If you have any queries about your diet, please contact us: Dietetic Department Dietetic Department George Eliot Hospital Warwick Hospital Author Department Registered Dietitian Dietetics Nuneaton Warwick Tel 024 76865098 Tel: 01926 495321 Ext 4258 Contact no 02476 865098/01926 495321 x4258 Published Sept 2013 Review Sept 2016 Version no 1 6
Appendix 1: Age 1-3 years Expected meal pattern: 3 meals and 2-3 snacks plus milk. If you choose to include the foods below, suggested age-appropriate portion sizes are listed. Foods Portions Example photos Bread ½ - 1 medium slice (15-30g) ¼ - ½ bagel Breakfast cereal 1-1½ tablespoons cereal (10-15g) ½ - 1 wheat biscuits Potato / rice / pasta 1-2 tablespoons mashed potato / cooked rice / cooked pasta (45-90g) 1-2 small potatoes 6-8 chips (30-40g) Fruit Note: as a general rule a child s portion of fruit is the amount that fits in the palm of their hand ½ - 1 small piece (40-80g) 2 tsp raisins (15g) 105ml fruit juice (+ water to dilute) 7
Vegetables 1 tablespoon (30g) Milk and dairy foods 165ml whole or semi-skimmed milk 1 standard pot yoghurt (100g) 20g cheese Meat / fish / egg / pulses etc 1-1½ tablespoons minced meat (30-45g) ½ chicken breast 1 slice cooked meat 1½ fish finger ½ sausage 2 tablespoons baked beans (75g) ¾ tablespoon houmous 70g fish or quorn pieces ½ - 1 egg Fats and Sugars 1 level teaspoon butter / margarine (5g) ¾ teaspoon oil (3g) 1 teaspoon honey (10g) Note: plates and bowls size 18cm / 7 ½ inches diameter (side-plate size) 8
Appendix 2: Age 4-6 years Expected meal pattern: 3 meals and 1-2 snacks or milky drinks. If you choose to include the foods below, suggested age-appropriate portion sizes are listed. Foods Portions Example Photos Bread 1 1 ½ slices (30-40g) Breakfast cereal 2-3 tablespoons cereal (20-30g) 1-2 wheat biscuits Potato / rice / pasta 2-3 tablespoons mashed potato (120g) / cooked rice (70g) / cooked pasta (60g) 3 small potatoes 10 chips (50g) Fruit 1 medium / 2 small pieces (80-100g) 2 ½ tsp raisins (20g) 145ml fruit juice 9
Vegetables 1 ½ tablespoons (45g) Milk and dairy foods 165ml semiskimmed milk 1 standard pot yoghurt (100g) 20g cheese Meat / fish / egg / pulses etc 2½ tablespoons minced meat (70g) 3/4 chicken breast 1 ½ slices cooked meat 2½ fish fingers 1 sausage 4 tablespoons baked beans (140g) ¾ tablespoon houmous 130g fish or quorn pieces 1 egg Fats and Sugars 1 teaspoon butter / margarine (8g) 1 teaspoon oil (5g) 1 ½ teaspoons honey (15g) Note: plates and bowls size 18cm / 7 ½ inches diameter (side-plate size) 10
Appendix 3: Age 7-10 years Expected meal pattern: 3 meals and 1-2 snacks or milky drinks. If you choose to include the foods below, suggested age-appropriate portion sizes are listed. Foods Portions Example Photos Bread 1 1 ½ slices (30-40g) Breakfast cereal 2-3 tablespoons cereal (20-30g) 2 wheat biscuits Potato / rice / pasta 3 tablespoons mashed potato(140g) / cooked rice (90g) / cooked pasta (65g) 3 small potatoes 12 chips (70g) Fruit 1 medium / 2 small pieces (80-100g) 2 ½ tsp raisins (20g) 170ml fruit juice 11
Vegetables 1 ½ tablespoons (45g) Milk and dairy foods 190ml semiskimmed or skimmed milk 1 standard pot yoghurt (100g) 20g cheese Meat / fish / egg / pulses etc 3 tablespoons minced meat (85g) 1 chicken breast 2 slices cooked meat 3 fish fingers 1 ½ sausages 5 tablespoons baked beans (160g) 1 ¾ tablespoon houmous 140g fish or quorn pieces 1 egg Fats and Sugars 1 teaspoon butter / margarine (12g) 1 teaspoon oil (5g) 2 teaspoons honey (20g) Note: plates and bowls size 18cm / 7 ½ inches diameter (side-plate size) 12
Appendix 4: Age 11-14 Expected meal pattern: 3 meals and 1-2 snacks or milky drinks. If you choose to include the foods below, suggested age-appropriate portion sizes are listed. Foods Portions Example Photos Bread 2 slices (60g) Breakfast cereal 3-4 tablespoons cereal (35g) 2 ½ wheat biscuits Potato / rice / pasta 4 ½ tablespoons mashed potato(200g) / cooked rice (115g) / cooked pasta (90g) 4 small potatoes 15 chips (90g) Fruit 1 large / 2 ½ small pieces (150g) 3 tsp raisins (25g) 200ml fruit juice 13
Vegetables 2 tablespoons (60g) Milk and dairy foods Meat / fish / egg / pulses etc 220ml semiskimmed or skimmed milk 1 ½ standard / a large pot yoghurt (150g) 25g cheese 3 tablespoons minced meat (85g) 1 ¼ chicken breast 2 slices cooked meat 3 fish fingers 1 ½ sausages 6 tablespoons baked beans (185g) 1 ¾ tablespoon houmous 165g fish or quorn pieces 1 ½ eggs Fats and Sugars 1 teaspoon butter / margarine (12g) 1 teaspoon oil (5g) 2 teaspoons honey (20g) Note: plates and bowls size 18cm / 7 ½ inches diameter (side-plate size) For children over 14 years, adult portions sizes can mostly be used. However as calcium requirements for teenagers are higher than those recommended for adults, it may be necessary to include extra dairy foods / foods rich in calcium. 14
Appendix 5: Family Portion Sizes This information can be given to families to provide guidance regarding suitable portion sizes. It displays portions appropriate for age 1-60 years. Weights or portions are exact and handy measures are approximate sizes please weigh the portion if you are unsure. All Plates / Bowls: size 18cm / 7 ½ inches diameter (small side plate size) 15
Starchy Foods: Bread / Rice / Pasta / Potatoes / Breakfast Cereals etc. Bread Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Puffed Rice 30g / 1 medium slice 40g / 1 ¼ medium slices 40g / 1 ¼ medium slices 60g / 2 medium slices 60g / 2 medium slices 60g / 2 medium slices Wheat Biscuits 15g / 1 ½ tablespoons 25g / 2 ½ tablespoons 25g / 2 ½ tablespoons 35g / 3 ½ tablespoons 35g / 3 ½ tablespoons 35g / 3 ½ tablespoons Mashed Potato 1 2 2 2 ½ 2 ½ 2 ½ 90g / 2 tablespoons 120g / 2 ½ tablespoons 140g / 3 tablespoons 200g / 4 ½ tablespoons 200g / 4 ½ tablespoons 190g / 4 tablespoons 16
Boiled Potato Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Rice 90g / 1 ½ 150g / 3 150g / 3 210g / 4 210g / 4 210g / 4 Chips 45g / 2 tablespoons 70g / 3 tablespoons 90g / 4 tablespoons 115g / 5 tablespoons 115g / 5 tablespoons 115g / 5 tablespoons Pasta 40g / approx 8 chips 50g / approx 10 chips 70g / approx 12 chips 90g / approx 15 chips 90g / approx 15 chips 90g / approx 15 chips 40g / 1 ½ tablespoons 60g / 2 ½ tablespoons 65g / 3 tablespoons 90g / 4 ½ tablespoons 90g / 4 ½ tablespoons 90g / 4 ½ tablespoons 17
Fruit and Vegetables Sweetcorn Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Plum 30g / 1 tablespoon 45g / 1 ½ tablespoons 45g / 1 ½ tablespoons 60g / 2 tablespoons 75g / 2 ½ tablespoons 60g / 2 tablespoons Raisins 100g / 1 150g / 2 150g / 2 200g / 2 ½ 240g / 3 240g / 3 Apple 15g / 2 teaspoons 20g / 2 ½ teaspoons 20g / 2 ½ teaspoons 25g / 3 teaspoons 30g / 4 teaspoons 30g / 4 teaspoons Fruit Juice 80g / ½ apple 110g / 1 small apple 110g / 1 small apple 150g / 1 medium apple 180g / 1 large apple 180g / 1 large apple 105ml 145ml 170ml 200ml 230ml 230ml 18
Milk and Dairy foods Milk Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Yoghurt 165ml 165ml 190ml 220ml 270ml 250ml Cheese 100g / 1 standard pot 100g / 1 standard pot 100g / 1 standard pot 150g / 1 ½ standard or 1 large pot 150g / 1 ½ standard or 1 large pot 150g / 1 ½ standard or 1 large pot 20g 20g 20g 25g 30g 30g 19
Protein Foods Minced Meat Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Chicken Breast 35g / 1 ½ tablespoons 70g / 2 ½ tablespoons 85g / 3 tablespoons 85g / 3 tablespoons 100g / 4 tablespoons 100g / 4 tablespoons Cooked Meat 45g / ½ breast 80g / ¾ breast 95g / 1 breast 105g / 1 ¼ breasts 130g / 1 ½ breasts 105g / 1 ¼ breasts Fish Finger 1 slice 1 ½ slices 2 slices 2 slices 2 ½ slices 2 ½ slices 30g / 1 ½ fish fingers 60g / 2 ½ fish fingers 70g / 3 fish fingers 70g / 3 fish fingers 100g / 4 fish fingers 100g / 4 fish fingers 20
Sausage Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Baked Beans 25g / ½ sausage 50g / 1 sausage 50g / 1 sausage 75g / 1 ½ sausages 100g / 2 sausages 100g / 2 sausages Houmous 75g / 2 tablespoons 140g / 4 ½ tablespoons 160g / 5 ½ tablespoons 185g / 6 tablespoons 230g / 8 tablespoons 200g / 7 tablespoons Fish 35g / ¾ tablespoon 35g / ¾ tablespoon 60g / 1 ¾ tablespoons 60g / 1 ¾ tablespoons 80g / 2 tablespoons 80g / 2 tablespoons Quorn Pieces 70g 125g 140g 160g 200g 180g 70g 130g 150g 170g 210g 190g 21
Fats and Sugars Butter / Margarine Age 1-3 Age 4-6 Age 7-10 Age 11-14 Age 15-18 Age 19-60 Oil 5g 8g 12g 12g 12g 12g 3g 5g 5g 5g 8g 8g Honey 10g 15g 15g 20g 20g 20g 22
Breakfast Lunch Dinner Appendix 6: Daily Food and Drink Tracker Please circle day: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Food Group: Fruit and vegetables Starchy foods (e.g. bread, rice, cereals, potatoes, pasta) Dairy foods (e.g. milk, cheese and yoghurt) Meat and vegetarian alternatives (e.g. fish, eggs, pulses) Fats (e.g. spreads, oils) Extras Recommended number of servings a day: Food Amount Total Did I keep to my plan today? 23