Healthy Eating for Kids and Teens

Developing healthy eating habits

Children develop a natural preference for what they eat most often and enjoy. The challenge is to make healthy choices appealing. No matter how good your intentions, trying to convince your eight-year-old that an apple is as sweet a treat as a cookie is not a recipe for success! However, you can ensure that your children’s diet is as nutritious and wholesome as possible, even when allowing for some of their favorite treats. You can please both your child’s palate and your sense of parental responsibility.

Because the childhood impulse to imitate is strong, the best move you can make to start your child off on the right dietary foot is to be a role model, so that when your youngster asks to taste what you're eating, your plate is filled with healthy selections. If you're asking your child to eat vegetables and fish while you graze on potato chips and soda, your actions will override your good intentions.

Top tips to promote healthy childhood eating

• Have regular family meals. Knowing dinner is served at approximately the same time every night and that the entire family will be sitting down together is comforting, which also enhances appetite, and provides a perfect opportunity for your children to share what's on their minds. Breakfast is another great time for a family meal, especially since kids who eat breakfast tend to do better in school.
• Cook more meals at home. Eating home cooked meals is healthier for the whole family and sets a great example for kids about the importance of food. Restaurant meals tend to have more fat, sugar and salt. Save dining out for special occasions.
• Get kids involved. Children enjoy helping adults grocery shop, selecting what goes in their lunch box, and preparing dinner. It's also a chance for you to teach them about the nutritional values of different foods, and (for older children) how to read food labels.
• Make a variety of healthy foods available and keep your pantry free of empty calorie snacks. Keep plenty of fruits, vegetables, whole grain snacks and healthful beverages (filtered water, milk, herbal tea, occasional fruit juice) around and easily accessible so kids become used to reaching for healthy snacks when they're hungry instead of empty calorie snacks like soda, chips, or cookies.
• Let them choose. Don't make mealtimes a battleground by insisting a child clean the plate, and never use food as a reward or bribe.

How can I get my picky child to enjoy a wider variety of foods?

Picky eaters are going through a normal developmental stage, exerting control over their environment along with concern about trusting the unfamiliar. This often goes along with the “separate compartmented plate” stage, where children don’t like one type of food to touch or mingle with another. Just as research has shown that it takes a number of repeated impressions before advertising convinces an adult consumer to buy, it takes the average child 8-10 presentations of a new food before he or she willingly accepts it.

If your child is otherwise healthy, eating only a few select foods for a little while will not have any adverse effect. So, rather than insist your child eat a food that is being rejected, try some of the following:

• Offer a new food only when your child is hungry and rested.
• Present only one new food at a time.
• Make it fun: a game, a play-filled experience. Cut the food into unusual shapes.
• Serve new foods with favorite foods to increase acceptance.
• Eat the new food yourself; children love to imitate.
• Have your child help to prepare foods. Often they will be more willing to try something when they helped to make it.
• Limit beverages. Picky eaters often fill up on liquids instead.
• Limit snacks to two per day.

Healthy eating for toddlers and young children

Starting to instill healthy eating habits in the toddler years is a great idea, as young children are very impressionable. Toddlers are introduced to new tastes and textures as they transition from baby food to “real” food.

Keep in mind that toddlers have very small stomachs – it may be better to feed them 5-6 small meals a day, rather than three large ones. Depending on your child’s age, size, and activity level, your toddler needs between 1,000-1,400 calories a day. It is perfectly normal for your child to be ravenous one day and shun food the next – appetites are often in flux at this stage. Don’t worry if your child’s diet isn’t up to par every day – as long as he or she seems to be satisfied, and is getting what you consider to be a well-rounded diet, you are probably doing just fine!

Nutritional needs of toddlers and young children

An important part of a toddler’s diet is calcium (they need about 500 mg/day), and the best source of this nutrient is milk. Until the age of two they should drink whole milk, but older toddlers can usually switch to 2% or skim milk if given the okay from your pediatrician. If your kids are lactose intolerant or just don’t like dairy, try to incorporate calcium-rich foods like fortified soy products, cereals, and orange juice.

Keep an eye on your child’s iron consumption, too – toddlers need 7 mg a day to prevent iron deficiency, which can affect growth, learning, and behavior. In infancy, breast-milk has a readily-absorbed type of iron, and baby formula and food is usually iron-fortified, so babies don’t need to worry about getting enough iron. After switching to “real” food, its important to ensure that your child is eating good sources of iron like fortified cereals, small amounts of red meat (like soft meatballs), or eggs.

The following is a basic nutrition guideline – consult your pediatrician to ensure you are meeting your child’s individual needs:

Dietary guidelines for toddlers and young children
Fruits and vegetables	Two servings each per day. These may be given as snacks, such as apple or carrot slices. Also try slipping in veggies in the form of soups.
Whole grains	Four daily servings. Can include buckwheat pancakes or multigrain toast for breakfast, a sandwich on wheat bread for lunch and brown rice or another whole grain as part of the evening meal.
Milk and dairy	Three servings, or one pint of whole milk per day. Cheeses, yogurt and milk puddings are useful alternatives.
Protein	Two servings a day. Encourage your child to try a variety of foods from this category, such as turkey, eggs, fish, chicken, lamb, baked beans, and lentils. NOTE: Nuts, although an excellent source of protein, are not a good choice for children under five due to the risk of choking.
Vitamins and minerals	Check with your child's doctor to be certain your child's diet is adequately meeting the recommended nutritional needs for this age group

Healthy diets for school-age children

Eating becomes a social activity in this stage of life. Your kids are probably spending more time in school than they do at home; eating meals at friends’ houses; and adopting eating habits from their peers. It can be difficult to ensure they are getting adequate nutrition when you are not always around to monitor their choices.

Because children are so impressionable at this stage, it’s very important to instill healthy attitudes toward food. One of the best ways to do this is through family mealtime. Studies suggest that children who eat regular family meals are more likely to eat fruits and veggies and less likely to fill up on unhealthy foods. Eating as a family also gives you the opportunity to catch up on your kids’ daily lives.

During family meals, you can “teach by example” by eating a wide variety of healthy foods, keeping your own portions in check, not overeating, and sharing feelings of fullness and satisfaction. Refrain from obsessive calorie counting or commenting on your own weight, so that kids don’t adopt negative associations with food. 

Nutrition guidelines for school-age kids

As children develop, they require appropriately sized portions of the same healthy foods adults eat, along with more vitamins and minerals to support growing bodies. This means whole grains (whole wheat, oats, barley, rice, millet, quinoa); a wide variety of fresh fruits and vegetables; a source of calcium for growing bones (milk, yogurt, or substitutes if lactose intolerant); and healthy proteins (fish, eggs, poultry, lean meat, nuts and seeds).

Contrary to what many parents believe, kids don't need large amounts of fat because they're "burning it off" by being active. But the kind of fat they're eating does matter. Butter on vegetables, avocados and corn chips (made with sunflower or safflower oil), pecans or walnuts are far preferable to French fries, donuts, candy bars or fast food cheeseburgers.

Dietary guidelines for school age children
Vegetables	3-5 servings per day. A serving might be one cup of raw leafy vegetables, 3/4 cup of vegetable juice, or 1/2 cup of other vegetables, raw or cooked.
Fruits	2-4 servings per day. A serving may consist of 1/2 cup of sliced fruit, 3/4 cup of fruit juice, or a medium-size whole fruit, such as an apple, banana or pear.
Whole Grains	6-11 servings per day. Each serving should equal one slice of bread, 1/2 cup of rice or 1 ounce of cereal.
Protein	Two to three servings of 2-3 ounces of cooked lean meat, poultry or fish per day. A serving in this group may also consist of 1/2 cup of cooked dry beans, one egg, or 2 tablespoons of peanut butter for each ounce of lean meat.
Dairy products	Two to three servings per day of low-fat milk or yogurt (1 cup=one serving), or natural cheese (1 1/2 ounces=one serving).
Zinc	A new study indicates that 20mg of zinc five times a week may improve memory and school performance, especially in boys. Good sources of zinc are oysters, beef, pork, liver, dried beans and peas, whole grains, fortified cereals, nuts, milk, cocoa and poultry.

The special nutritional needs of teenagers

This is growth spurt time: kids gain about 20% of adult height and 50% of adult weight during adolescence. Because growth and change is so rapid during this period, the requirements for all nutrients increase. This is especially true of calcium and iron.

Eating habits, however, are pretty well set by now, and if your child's choices are less than ideal, it's a challenging time for a course correction; teens have other priorities. The best way to make teen dietary changes is by presenting information about short-term consequences that they can relate to: appearance, athletic ability, popularity and enjoyment of life, because these are more important to most teens than long-term health. For example, “Calcium will help you grow taller during your growth spurt.”  “Iron will help you do better on tests and stay up later without being as tired.”

When you do speak of long-term consequences, link them to the things that teens care about—particularly body image. For instance, “You know how some old men and women are bent over when they walk, and others are strong and active? One of the biggest differences was how much calcium they got every day when they were your age..." It's a fine line between teaching and preaching, but will pay big health dividends down the line.

Special nutritional needs for teens
Calories	Due to all the growth and activity of this time, adolescent boys need 2500-2800 per day, while girls need around 2200 per day. It’s best to get these calories from lean protein, low-fat dairy, whole grains, and fruits and veggies.
Protein	In order for the body to grow and maintain muscle, teens need 45-60 grams per day. Most teenagers easily meet this need from eating meat, fish, and dairy, but vegetarians may need to increase their protein intake from non-animal sources like soy foods, beans and nuts.
Calcium	During puberty, your child’s body will naturally “grab” all the calcium it can, to ensure strong bones in the future. Unfortunately, many teens do not get sufficient amounts of calcium, leading to weak bones and osteoporosis later in life. Encourage teens to cut back on soda consumption and other overly sugary foods, which leech calcium from bones, and to get the 1200 mg of calcium needed per day from dairy, calcium-fortified juice and cereal, and other calcium rich foods such as sesame seeds and leafy greens like spinach.
Iron	Iron is needed to help new muscle mass gained in adolescence to obtain energy. Iron deficiency can lead to anemia, fatigue, and weakness. Boys need 12 mg each day, and teen girls, who often lose iron during menstruation, need 15 mg. Iron-rich foods include red meat, chicken, beans, nuts, enriched whole grains, and leafy green veggies like spinach or kale.

A “weighty” problem: children, weight and self esteem

Sometimes, parents who are concerned about their child’s appearance, popularity, and future opportunities may over-react to what is actually a normal, healthy weight for that particular child. Many adults, particularly women who have constantly struggled with dieting and weight problems, say their problems began when their mothers put them on a diet at age 9-12. Before deciding that your child has a weight problem, consider:

1. Is your child within the “normal” range on charts for his/her age and height?
2. Is your child’s body type simply a refection of his/her genetic heritage for a stockier build?
3. Is your daughter approaching puberty, when normal developmental changes include the addition of body fat?
4. Did you have your own childhood or adolescent issues with weight that may be causing you to be overly concerned about your child’s weight?

After careful consideration and consultation with your pediatrician and/or a nutritionist, if you have done everything you can with healthy food and your child is tending toward a weight problem, the key is to add exercise – which means turning off the TV!

To encourage physical activity, play with your kids - throw around a football; go cycling, skating, or swimming; take family walks and hikes; and help your kids find activities they enjoy by showing them different possibilities. By encouraging healthy eating and physical activity for your entire family, you’ll be giving your children the best opportunity to grow into healthy, confident adults!

Kids and junk food

If you've been following the guidance and suggestions given so far your kids are probably well on their way to lifelong healthy eating habits. But outside forces can make it difficult for kids to avoid the siren song of junk food. Even at school, vending machines and unhealthy cafeteria choices can be pitfalls to healthy eating. Parent activism can make the difference in school nutrition: under pressure from parents, some schools now ban soft drinks and junk food altogether; others have installed vending machines that offer healthy alternatives.

At home, if your kids are clamoring for junk food, you can try substituting some healthier alternatives, such as:

Kid-friendly junk food alternatives
Instead of…	Try…
French fries Ice cream Fried chicken Doughnuts or pastries Chocolate-chip cookies Potato chips	“Baked fries” – sliced potatoes, grilled in oven and salted lightly. Low-fat frozen yogurt; sorbet; fresh fruit smoothies Baked or grilled chicken Bagels; English muffins; home baked goods with less sugar/fat Graham crackers, fig bars, vanilla wafers, fruit and caramel dip Pretzels, unbuttered popcorn, baked potato chips, soy crisps

Eating out with kids: fast food and restaurant nutrition for children

Nearly one-third of children eat fast food every day, and those children who do eat fast food tend to consume more calories on a daily basis. These increased calories lead to increased pounds and add to the child's risk of becoming overweight.

Granted, it might still be challenging to persuade your youngster to order a salad instead of a cheeseburger, but you can steer them towards healthier options. Some important tips to remember about fast food/restaurant dining for kids:

• Soft drinks are highly caloric and not nutritious – kids should have water or milk instead.
• Avoid chicken nuggets – sorry imposters of real chicken.
• Skip the fries – Consider taking along a bag of mini carrots, grapes or other fruits and vegetables to have instead. This will add vitamins and fiber to the meal.
• Order the kid's meal with some substitutions – Children often love the kid's meal more for the fun box and toys than for the food. Ask to substitute healthier choices for the soda and the fries if possible. Many restaurants are making it easier to substitute, and all usually have water and milk available as beverage options. In sit-down restaurants, help them opt for chicken and vegetables or spaghetti with tomato sauce rather than a big plate of macaroni and cheese.
• Remember that you are modeling food habits – When you are eating out with the kids, follow healthy eating guides yourself! Kids are much more likely to do as you do, not as you say.

Related links for healthy eating for kids and teens

General information on nutrition for children

The New Food Guide Pyramid – Article aimed at kids explains exactly how much of each food group children need to eat to stay healthy, according to the new food guide pyramid. (Kids Health)

Child & Adolescent Nutrition – Information on nutrition guidelines for children from infancy through adolescents. (International Food Information Council)

20 Tips for Picky Eaters – Practical tips to avoid mealtime battles. (Mayo Clinic)

The Stay-trim Family Diet – This article talks about common eating pitfalls and what you can do to help your family avoid them. (Delicious Living magazine)

Healthy eating for toddlers and young children

Healthy Eating, Part II and Healthy Eating, Part III (commercial site) –How to differentiate healthy from unhealthy choices for children, and the five greatest motivators for preschool children to eat healthy foods. (DrGreene.com)

Eating Tips for Children: Young Toddlers – Parental concerns and unique challenges of feeding toddlers. (Better Health/Victoria, Australia)

Eating Tips for Children: Older Toddlers – Tips to get finicky eaters on the right track. (Better Health/Victoria, Australia)

Nutrition for school-age kids

Eating Tips for Children: Primary School – The importance of breakfast, dealing with peer pressure around food, exercise and snack ideas. (Better Health/Victoria, Australia)

Early Childhood and School Age – Very detailed information on nutritional needs of children (George Mateljan Foundation)

Nutrition for Kids: Guidelines for a Healthy Diet – Offers exact nutritional needs for different age groups and genders. (Mayo Clinic)

School Lunches – Suggestions for helping kids make better cafeteria choices; ideas for packed lunches that satisfy and taste and nutrition concerns. (Nemours Foundation)

Healthy eating for pre-teens and teenagers

What’s the Right Weight for Me? – A child’s guide to understanding body type, calories, exercise, and how to maintain optimal weight. (Kids Health)

Healthy Eating For Teens – Good summary of nutritional needs of teenagers, including a chart of recommended servings of different food groups. (Nutrition.com.sg)

Kids and junk food

Junk Food vs. Healthy Nutrition for Children – How to help your child maintain a healthy diet, regardless of adverse influences. (MedicineNet – commercial site)

Parents Against Junk Food – Non-profit organization dedicated to making sure healthier choices are available in schools. Includes links to local organizations that create positive change in school systems.

Maya W. Paul, Suzanne Barston, and Jaelline Jaffe, Ph.D., contributed to this article. Last modified: August 09.