Toddler Food: A Guide to a Healthy Preschool Diet

by Mike Howard

Just when we thought we were finally doing something nutritionally sensible... It seems that nurseries are taking the campaigns of eating more fruits and vegetables too far - neglecting other dietary needs that may lead to nutritional deficiencies that can impact development.

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Neil Leitch, director of Feeding Young Imaginations, said that years of campaigning for "healthy" foods had ignored the needs of the under-fives. It would appear that preschools (and likely well-intentioned parents too) are applying the guidelines intended for school-aged children to their toddlers.

Experts say that this kind of focus tends to leave out necessary fats and may provide too much fiber and not enough calories.

Says Leitch "What is needed is emphasis on providing a balanced diet - with information on just what a balanced diet is to aid people looking after kids". Absolutely!

Although problems can arise from these situations, in my estimation it is better than children snacking on refined, empty calorie foods. Further, this problem needn't exist at all if parents provide a well-balanced diet when their children are at home. This also emphasizes a need for well-publicized guidelines specific to this age group.

Here are some guidelines for keeping pre-schoolers well nourished:

Basic Recommendations

2-3 Cups of milk products (or high calcium alternative): In addition to milk, this may include yogurt (2%+ Fat), cheese or cottage cheese.
4 Servings of Fruits and Vegetables: 1 Tablespoon serving per age is the recommended helping here. Go for a variety of color (leafy greens, peppers, tomatoes, apples, oranges, kiwis).
4 servings of bread and cereal: Whole grain cereal, bread and pasta are good choices. A serving size is about 1/4 to 1/3 an adult portion. e.g 1/4 slice toast, 1/4 cup pasta
2 servings of meat, beans, eggs, tofu: A good serving of protein should be fed at every meal. One serving equals 1/2 ounce.

10 Tips for Setting your Toddler up for Eating Success

Here are some tips I've read about and ones I've learned from experience (sometimes the hard way).

Set a good example: Eating well most of the time as parents will help role-model healthy living to young ones.
Involve your child in meal preparation
Expect child-like table manners and allow them to play with their food
Serve meals and snacks on a dependable schedule
Offer new foods 1-2 times a week: Try and offer these alongside old favorites
Serve small, bite-sized portions
Serve colorful and attractive foods: By colorful, think colorful fruits and veggies - not fruit loops. Make dishes attractive by putting food in the shape of a face, animal, etc. Be creative!
Limit juice and other sugary beverage consumption
Avoid using food as a bribe, reward or punishment
Eat as a family as much as possible

References:

Nutritional Guidelines for Toddlers. Sue Gilbert, M.S.

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40 Comments

Heather

I need to bookmark this...

Never teh Bride

In my family, the big issue was simply getting them to eat much of anything at all. All of my siblings ate like birds -- a few bites and they'd be clamoring to get down from the table. They weren't big snackers and water was the drink we were most often allowed, so I often wondered just where their calories were coming from. But they all grew up strong and healthy, so they must have been getting enough food.

angela kc

For anyone looking for information, detailed or specific, about feeding babies and toddlers, I would recommend Ellyn Satter's Child of Mine. There is more information than most people will ever want or need about nutritional needs, feeding, etc. The take home message (at least what I got out of it) is that if you make a variety of healthy, wholesome food available to your children, they will take what they need in terms of calories, macronutrients, vitamins, etc -- that their bodies will tell them how much they need, of what.

Of course, the person who is responsible for feeding the child must make a variety of food available -- if a child is only given access to steamed vegetables and the occasional piece of fruit, he or she will obviously not be able to meet his or her nutritional needs. I suppose that is still preferable to feeding kids on goldfish crackers and lunchables (which are an absolute abomination -- anyone who reads the ingredients on these things should be appalled that they are marketed to growing little people), in which case the child not only has no nutritional options at all, but also develops a taste for chemicals, garbage, and all the other unpronounceable nastiness that is in today's non-food.

Regina

While the basic recommendations above look nice and seem simple to follow, they're totally inadequate for meeting energy requirements for a toddler (under 5) and worse, they're deficient for micronutrients (vitamins, minerals, trace elements, amino acids and essential fatty acids).

soozeequeue

Do you have or feed a toddler? Just curious, because they can be harder to get food into than you think. Somedays their diet reads more like - a few cheerios, some lint off the carpet, a few apple slices, some playdoh, a cup of milk, no make that half because the other half went on the floor, some macaroni and cheese, good for painting the wall with, some dirt from the sandbox, two centimetre square cubes of chicken, 7 similar sized pieces of carrot, two green beans and one pea, and a small dish of chocolate pudding - good contrast color for painting the wall with again. If you can get in what is on the list on any given day, I'd say your'e doing pretty good. There is a vast difference between providing food for the toddler and actually getting it into the toddler.

Regina

As a matter of fact, I do....he's 3 1/2 and eats well, thank you very much!

While some days it seems like he lives on air, most days he's really good about eating a wide variety of foods.

Today, for example, he's had plain whole-milk yogurt with blueberries mixed in (mashed a bit to make the yogurt purple, but no added sugar to it), 2 slices raw cheddar cheese, some whole milk, an egg, some cut up roast turkey, some green beans, a bit of three bean salad, a kiwi, and crackers with almond butter, which he licked the almond butter off and tossed the crackers (go figure)...and tonight for dinner he'll have sliced cucumbers & tomatoes with ranch (he's not a fan of lettuce, so that's his salad), wild salmon in a lemon butter dill sauce, and more green beans with slivered almonds.....we don't routinely serve dessert in our house.

That's pretty much how he eats all the time.

Regina

Oh, and in my comment, the point was that if you simply follow the basics presented, it's not enough calories for a toddler under five and presents significant challenges to meeting their nutrient (micronutrient) requirements to allow for proper growth and development....that the above is not a solution as it is presenting a new problem - deficiency - just like the well intentioned policies to increase fruits and vegetables and fiber at the nurseries surveyed did. IMO feeding kids isn't all that hard (based on my experience) and those giving recommendations should be cognizant not just of "food groups" but if what they're recommending actually meets calorie and nutrient requirements and the above don't.

soozeequeue

But you're basing your assumption that kids are easy to feed on your one kid. I had one like that, and then one not so much. It does, as Jade says below, have a certain element of fate to it, not parental effort. My sister in law just about went nuts because no matter what she did their kids only ate cheerios and raisins for the first 10 years of their life.

MY point was that sometimes we are lucky if our children eat anything at all, and I don't think you would find many doctors complaining if you managed to get all the food on the list into your kid on a more or less daily basis. If your thing is that you want to look into making sure that you are getting certain macronutrients into your child within those groups, if you have a child who will cooperate, and if you have the time, that's terrific.

But when you say the list is not enough, and you have parents struggling to get even that into their kids, it can be discouraging, and you have people (see Judy's comment) feeling like they are failing. I worked as the director of a pre-school parenting organization for many years, and I grew weary long ago of the way moms are often the best enemies of their peers - even if they don't mean to criticise.
Once, when I said my kids were drinking whole milk, a nutritionist went on about how I should be making some smoothie with flax seeds and a host of other (at that time) hard to find ingredients. The hardest ingredient on that list for me to find would have been time!

Regina

So because Judy (or others) may feel like a failure, I should say nothing? I should applaud recommendations that lead to malnutrition if followed? I should be quiet and not say anything about potential deficiencies - just to make an adult feel better?

Nope, no can do - if the recommendation is flawed, deficient for nutrients (micronutrients) and is going to fail to provide adequate energy for a growing child....guess what? I'll say something!

Mike H.

Hi Regina,

Your toddler's meals sound a lot like how we feed our 2 year old! The basic recommendations are just that - basic. They can certainly meet the requirements for a toddler if you have enough variety. Some will eat more than this, some will eat less - however I think most kids come out alright. I don't see any major nutrient deficiencies plaguing north american children.

I realize you can be overfed/undernourished (and it's becoming more and more common) I just doubt a child would become so following those basics with some variety.

I think soozeque and Spectra and others are bang on when they say it depends on the kid. I think it's important the give them a healthy eating environment but also not to stress out if your child may not be getting the RDI for every vitamin/mineral. I think you have to be diligent in presenting healthy options on a day-to-day basis, but you have to let the chips fall where they may when it comes to individual eating habits.

I am blessed to have a 2-year-old who eats very well. He has his favorites (a carb junky like mom and dad) but he eats veggies, fruit, salmon, turkey, almond butter etc... I also realize that our daughter (who is still on breast milk and baby cereal/puree fruit/veg) may not have the same affinity for food as our son.

soozeequeue

Thanks Mike, I always liked to remind parents as a parenting educator that it's important to take time to just enjoy your kids. They will make it to adulthood as relatively intelligent healthy people in spite of us, unless we encourage them to lick lead paint. It's about the big picture. You can get so wrapped up in these toddler issues - nutrition, toilet training, learning styles and stages, speech, discipline - that you lose sight of the goal. A year or two down the road - especially if you add a second child or more - you ask yourself what all your fuss was about. I remember driving myself nuts for a couple of weeks because I thought my one year old wasn't getting enough iron, and is he iron deficient at age 11? Nope. With the second I made myself crazy because he wouldn't get out of diapers and wouldn't get to go to preschool - and then I reminded myself, it's only preschool and let it go. And did he abandon the diaper on his own and make it to school? Of course.

Spectra

I think too much information sometimes overwhelms parents these days. Back when I was a kid, our parents didn't have as much knowledge about these things. My sister was a little bit less cooperative when it came to eating and even though my parents tried to get her to eat a variety of foods, she was very content to eat crayons, chapstick, paste, and play-doh lots of the time. My parents just kept on trying with her though...they persevered and tried to get her to try foods over and over again. Once she was about 4 or 5, she grew out of her "phase" and she began to eat normally. My parents didn't freak out about it, probably because she was growing pretty normally despite her erratic eating patterns. I'm pretty sure that as long as your kid is growing at a pretty good rate, you shouldn't freak out that he/she won't eat kale or radishes or broccoli. I know my parents always gave us a Flintstones vitamin every day, just to make sure we got any vitamins that we didn't get from our food.

Mike H.

Appreciate the encouraging words, soozeeque.. I think it's an important message for parents and I'm glad that that people like you are around to spread that kind of knowledge.

Regina

Some will eat more than this, some will eat less - however I think most kids come out alright.

I agree that most kids come out all right when they're fed a healthy varied diet.

I don't see any major nutrient deficiencies plaguing north american children.

You may want to read more into the literature - it's well documented that the prevalence of micronutrient deficiency in the United States (and many western countries) is quite high.

For example, iron deficiency is found in 6-18% of all children under 12 (White); 91% of children 2-5 surveyed had inadequate intake of vitamin E, 68% were deficient (Drewel et al); NHANES data suggests the majority are also have inadequate intake of or are outright deficient for vitamin C, vitamin A, vitamin D, selenium, potassium and magnesium and that vitamin K may be problematic, and a small number are consuming too little potassium, zinc and copper.

A large number of children are deficient for omega-3 fatty acids in their diet and/or are consuming levels of omega-6 at too high a level.

You may not be seeing it, but it's out there.

I think anyone making recommendations about how a child should eat has the onus on them to ensure what they're presenting is adequate for nutrients, and the above suggests fall short - on some things severely (like vitamin E).

Yes there is the "real world" where how kids eat is how kids eat...but as someone offering parents advice, one must try to provide sound, solid information that is based on optimium for nutrition each day.

As parents we don't always get it perfect, nor are we supposed to...but if we don't have the information to target accurately we're set up to fail - at least if we have information about what meets nutrient requirements, we then have a shot at understanding how and why a child may miss and work on that. Ya know what I mean?

angela kc

Well, speaking of saying nothing... um, does your child have some sort of medical condition that prevents you from even *offering* him whole grains? I understand that you are a low-carber, but have you had your pediatrician or a nutritionist who specializes in children sign off on the diet you are feeding your child? A child's nutritional needs can vary significantly from an adult's. It does not seem to me that he would be getting all the micro-nutriends based on the diet you are giving him.

Of course, maybe this is just more of that game that we mothers play, constantly judging each other on criteria that mostly exist only in our own heads.

Also, I would like to echo that the recommendations above are bulleted under 'basic recommendations' -- I think that means that these are meant to be sort of minimum requirements. Also, I seem to recall from what I have read about children's nutrition that the serving size for carbs for a toddler it is meant to be half the serving size for an adult (e.g. half a slice of bread). Noting that, a quick eyeballing of the recommendations looks like it should provide a good base for a toddler's diet.

Regina

um, does your child have some sort of medical condition that prevents you from even *offering* him whole grains? I understand that you are a low-carber, but have you had your pediatrician or a nutritionist who specializes in children sign off on the diet you are feeding your child? A child's nutritional needs can vary significantly from an adult's. It does not seem to me that he would be getting all the micro-nutriends based on the diet you are giving him.

Do tell, what micronutrient did he miss? The only change from the above foods listed was at dinner - we had spinach instead of green beans. Oh, and he gets a half tsp of fish oil a day that wasn't listed above.....so what did he miss nutritionally?

You're making an assumption that his diet is low-carb, it's not...he ate 85g of carbohydrate yesterday, of which 15g was fiber. How many toddlers out there are routinely consuming 15g of fiber? How many out there routinely meet and/or exceed micronutrient requirements, as defined by the IOM (Institute of Medicine) for children?

Run the numbers yourself...he hit every target at or above, without exceeding upper tolerable limits, for EVERY micronutrient defined as essential to health, including fatty acids and amino acids.

But yeah, I should add in whole grains? Exactly why? Adding in whole grains, to an already nutritionally complete diet, is adding calories that he doesn't need - so what nutrient-dense food above would you take out to put in whole grains? Anything you pull out is going to impact the nutrient content negatively....so again, why do I need to add in whole grains?

The above provided him with 1700 calories in the day - so he's doing just fine energy wise.....and considering he's in the 7th percentile for BMI for age, I don't think he's at risk for obesity.

And to answer your assumptive question - nothing prevents me from offering him whole grains....THEY ARE OFFERED - he doesn't like them and simply won't eat them all on his own.....should I force him to eat them?

angela kc

Regina said:

Run the numbers yourself...he hit every target at or above, without exceeding upper tolerable limits, for EVERY micronutrient defined as essential to health, including fatty acids and amino acids.

[sorry I'm not sure how to make it do quotes]

I was actually interested in doing that, but I don't have complete information here about amounts.

A quick glance at the list you provided does make me wonder where his iron is coming from. That is one area where whole grains can be helpful.

Is he really eating 1700 calories a day? Isn't that on the high side for a child that age? Based on the information you provided, granted I am missing some quantities, it doesn't seem like 1700 calories to me. If that is the right number, and if he is getting 85 grams of carbs, that is 340 calories from carbs so 20% of calories from carbs? You can absolutely correct me if that is wrong, I am awful at math and I haven't done carb calculation in a while. I think 20% of calories from carbs is low-carb, even for an adult. How do you define low-carb?

Pardon the 'assumptive question' -- this was based on your notation that you offered crackers but he did not eat them. You did not mention offering any other grains.

Regina

Is he really eating 1700 calories a day? Isn't that on the high side for a child that age?

How do you define on the high side of calories? I've said it in comments in other posts here and on my blog, it is extremely difficult to accurately nail down calorie requirements for kids because they're always growing and going through spurts and then nothing for weeks to do it all again!

He eats what he wants, in as much quantity as he desires and usually falls between 1400 and 1900 calories a day, which seems to keep his growth right where it is to be expected - as I said some days it seems like he lives on air, other days he chows down....and it all seems to work out since he's growing and gaining weight appropriately.

There are places online one can get some pretty good estimates by way of online calculators:

USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine
'Energy Calculator' Could Help Kids Balance Diet, Exercise

Input:

3 years, 9 months
41.5" tall
35 pounds
1-hour+ per day active

Calculation returned:

"Your child needs about 1919 calories a day"

-----

Is that accurate?
It's close....another one, at Kids Nutrition

Input:

3 years, 9 months = 3.75 in the age box
41.5" tall
35 pounds

This one returns his needs in their calculator at 1880 a day if he's very active (which he is) and 1610 a day if he's moderately active, so 1700 is in the range.

So no, I don't think his caloric intake is on the high side.

-----------------------------------------

A quick glance at the list you provided does make me wonder where his iron is coming from. That is one area where whole grains can be helpful.

Grains only have iron because they're fortified with iron. The DRI (from the IOM publications) for his age is 7mg....he consumed 10mg yesterday - small amounts add up....and there is iron in the spinach, milk, yogurt, salmon, turkey - there's some in the nuts and almond butter....so, no adding grains wouldn't be helpful for iron since he's already doing just fine for intake.

--------------

You didn't answer what foods you'd pull/swap out to incorporate whole grains, and since you considered his 1700 calories on the high side, I doubt you would suggest "adding" more calories in just to get grains in....it doesn't really matter though - he doesn't like them....so if I put 'em on his plate, ahhhh, then I too would have a picky eater on my hands, wouldn't I?

Rice? Won't touch it

Pasta? Says it takes weird

Bread? Won't eat anything except a bite occasionally of crusty bread (won't even take a bite of soft loaf slices) and will occasionally ask for some rye bread (fresh made stuff, crusty loaf type, not the soft type)

Oatmeal? Won't touch

Cereals? Won't touch other than an occasional few "O's", takes a few and then winds up asking for some cheese or fruit or something else

Potatoes? Won't eat 'em....not even french fries (I'm blessed, I tell ya!)

Quinoa? Won't touch, says it smells funny

Cereal bars? Won't touch 'em (and personally I'm glad, they have too much sugar in them)

Corn? Last summer he managed 1/2 an ear...since then says he doesn't like corn (fine by me)

Crackers? They're a vehicle to get something to his mouth...usually he just eats whatever is on the cracker and tosses it...oh well

Buns on things like burgers or hot dogs? He takes either out of the bread and just eats the burger or the dog....cool by me

So what exactly should I do to make him eat grains? And....why does he need them if his diet is already nutritionally complete?

angela kc

Hi Regina

Again, I don't know how to make the nice quote-y thing work, so I will just add a couple of points.

1. calorie requirements. I thought your numbers were really interesting. Actually what I thought was really interesting was the variations in requirements I found. Health.gov and some others gave 1,000-1400 calories as the range for a very active 2-3 year old. Other sources gave the same or similar numbers that you did. 1700-1800 still seems high to me for a child that age, unless he spends all day bouncing off walls, but at the end of the day I don't really like the idea of counting calories, especially for kids -- as I said earlier, I think that a child who is given a wide variety of healthy foods to choose from will take what he or she needs, barring interference from adults.

2. Iron. I think this is a really important point. I probably should have put it first, but oh well. Many whole grains are naturally fairly high (not calf liver high, but still respectable) in iron. Iron fortification, for the most part, is only found in really processed (i.e. white) grains, and the reason it is there is to try to put back some of what they took out when they stripped the grain of most of its nutrients.

Cow's milk does not contain iron. Not only that, but the calcium will interfere with iron absorption.

Salmon does not contain significant amounts of iron. One ounce of salmon (the recommended serving size for a 3-5 year old) has .2 mg of iron. One ounce of cooked spelt (about 1/2 to 1/3 of a serving size) (the first grain I chose to look up, other grains may have more or less), by comparison, has .5 mg.

I am not seeing from your number how he got 10mg of iron from the foods you listed, but again I don't have the exact quantities of food he ate in front of me, so hard to say.

3. what food would I pull out to replace with grains? It seems to me that he is getting more dairy than he needs, and I don't see a lot of nutritional value to dairy, besides calcium and vitamins A and D (which are just fortifications, not nutrients naturally found in milk). Riboflavin, I suppose, and B12, but he would be getting that from the meat anyway. Protein, but ditto. So if I were to replace something, that is obviously where I would go.

Having said that, I would not *replace* any of it. It's not like you're giving your kid junk food. I personally would like to see more whole grains, and I think less dairy (especially if he is getting conventional, as opposed to organic, dairy) would be a good thing. I personally would offer both, at every meal, and trust him to take what he needs. But, at the end of the day, you're not going to sit there and pry his mouth open and force him to eat stuff he doesn't like. If your son, despite your best efforts, just doesn't like grains, that's just the way it is.

It is striking, however, to look at an example of what he ate for a day, and see a complete absence of an entire category of food. In one comment you say that they are offered, and in the next you suggest ("so **if** I put 'em on his plate... then I too would have a picky eater") (asterisks mine) that they are not. I don't know which it is, but it concerns me that your personal choice to eat a low-carb diet may be keeping you from encouraging him to eat a wide variety of whole foods. Maybe you think grains are nutritionally deficient (as your belief that they only contain iron because they are fortified suggests), but you must realize that you are in a very small minority there.

Finally, I still haven't seen exact amounts for most of the foods you mentioned giving him that one day, so I am unable to verify your assertion that his diet is 'nutritionally complete.'

Regina

Health.gov and some others gave 1,000-1400 calories as the range for a very active 2-3 year old. Other sources gave the same or similar numbers that you did.

Considering he's nowhere near being at risk for overweight/obesity his calorie intake is appropriate for him, and as I said above, it does vary...it's not static each day, nor do I count his calories purposefully - they are what they are, and what he ate in one day is merely one day of what he eats.

at the end of the day I don't really like the idea of counting calories, especially for kids -- as I said earlier, I think that a child who is given a wide variety of healthy foods to choose from will take what he or she needs, barring interference from adults.

I do not like the idea of parents counting calories either - but would add that a wide variety of foods needs to include a variety that actually has the potential to meet all nutrient requirements and not simply a variety from a set of "food groups" with the assumption that *all* must be offered and consumed to meet nutrient requirements since that clearly is not the case.

Iron. I think this is a really important point.

Considering he's consuming adequate iron in his diet and he is not suffering iron deficiency, I'm not sure why you feel this is such an important point to continue with.

Cow's milk does not contain iron. Not only that, but the calcium will interfere with iron absorption.

Actually it does, in small amounts - and small amounts over the day from all sources of food add up.

One the day we're discussing, my son's richest sources of iron were from spinach and green beans - but almost everything in his day had some iron (except the butter, blueberries, olive oil, fish oil, ranch dressing and lemon) - all totaled his intake was 10.04mg.

I am not seeing from your number how he got 10mg of iron from the foods you listed, but again I don't have the exact quantities of food he ate in front of me, so hard to say.

Considering I haven't asked you to specifically analyze his iron intake, it doesn't matter much if you know the exact quantity of anything he ate - I do, I ran the numbers, I know he hit all DRI's for the day.

Wild Coho salmon (as per USDA Nutrient Database) has 0.40mg in 2-ounces (about what he ate, so that's what I used as the input amount) cooked with moist heat....again, as I've said before, all amounts add up and even though it seems like a small amount, for a three year old child 0.40mg is 5.5% of the DV - not a trivial amount.

More importantly though is the salmon has omega-3 fatty acids, nice levels of potassium, phosporus, selenium and B-12, B-6, and riboflavin.

what food would I pull out to replace with grains? It seems to me that he is getting more dairy than he needs, and I don't see a lot of nutritional value to dairy, besides calcium and vitamins A and D (which are just fortifications, not nutrients naturally found in milk). Riboflavin, I suppose, and B12, but he would be getting that from the meat anyway. Protein, but ditto. So if I were to replace something, that is obviously where I would go.

More dairy than he needs?

You're assuming he consumes that much dairy each day...

I think less dairy (especially if he is getting conventional, as opposed to organic, dairy) would be a good thing.

LOL - you may want to read my blog....he gets vat pasturized non-homogenized cow milk; vat pasturized non-homogenized goat milk; raw cheese varieties and/or organic grass-fed only (cow and goat); plain whole-milk organic yogurt (both cow and goat); butter is grass-fed organic (cow and goat)...he also likes kefir, which is also organic.

personally would offer both, at every meal, and trust him to take what he needs.

You're assuming he hasn't had such opportunity presented to him past or present to be able to make such choices. He has and on his own he shuns most grains and most starchy foods - and even those he does like and does eat, the amount he will eat, on his own, is small.

It is striking, however, to look at an example of what he ate for a day, and see a complete absence of an entire category of food.

What food category is that? He was given and did not eat whole grain crackers....so your assertion of a "complete absence of an entire category of food" is inaccurate and false.

It seems you assume that grains are somehow essential for health and well-being, for proper development in children, for growth and such. Please tell me what disease is he at risk for from "grain deficiency"? What exactly is he missing in his diet that can only be had with grains at each meal?

In one comment you say that they are offered, and in the next you suggest ("so **if** I put 'em on his plate... then I too would have a picky eater") (asterisks mine) that they are not. I don't know which it is, but it concerns me that your personal choice to eat a low-carb diet may be keeping you from encouraging him to eat a wide variety of whole foods.

Well, let's see - you think I should serve grains at every meal....despite the fact that he has clearly communicated, a number of times, he doesn't like most of them, refuses to eat most of them, and even when he does eat some, it's (at most) a bite or two....me knowing this after feeding him for years?

Sure - waste my time, my money and food...just so it can be said grains are on his plate so he can look at it, toy with it, push it around -- all the while as he digs into his meat/fish/fowl/game, vegetables, fruit, beans, etc. -- to leave it, uneaten, so I can throw it away after each and every meal?

You assume that

A) we don't ever serve grains (incorrect)
B) we don't ever eat grains (incorrect)
C) we don't let him have grains (incorrect)

But worse - D) that somehow he's missing something without many grains each day!

As you said "Maybe you think grains are nutritionally deficient (as your belief that they only contain iron because they are fortified suggests), but you must realize that you are in a very small minority there."

Opinions do not over-ride facts, and the fact is that grains are an inferior option nutritionally when compared with other foods.

When it comes to diet, the sum of the entire diet is much more important than any single food group. Context of the diet matters, nutrient-density matters, and overall quality matters. Considering he is consuming a diet that is nutritionally complete, how much grain he eats or doesn't eat isn't an issue IMO as long as he's routinely meeting DRI's from what he eats and his growth and development are excellent.

Regina

If that is the right number, and if he is getting 85 grams of carbs, that is 340 calories from carbs so 20% of calories from carbs? You can absolutely correct me if that is wrong, I am awful at math and I haven't done carb calculation in a while. I think 20% of calories from carbs is low-carb, even for an adult. How do you define low-carb?

I forgot to answer this before.

Within the research community, low-carb is generally defined and accepted as less than 60g per day of carbohydrate.

...he's certainly not eating high-carb/low-fat, but he's also not eating within the generally accepted definition of low-carb either....I don't purposely exclude foods like grains (if they're offered and he refuses, that's fine...if he's offered something multiple times and refuses again and again, that's fine....if something is offered and he likes it and eats it, cool by me too, he can have more of it anytime he'd like....but I am not going to MAKE him eat something he clearly isn't interested in eating)and thus far his growth and development are great, he eats well and he actually prefers "real food" to packaged processed foods or things like fast food.

Regina

but have you had your pediatrician or a nutritionist who specializes in children sign off on the diet you are feeding your child?

No one needs to sign off on my child's diet - not when he routinely - day in day out - meets and exceeds nutritional requirements for all micronutrients.

Mike H.

Regina again I'll emphasize that what I provided were BASIC GUIDELINES, otherwise the title would have read:

Specific, not-to-be-altered, surefire way to feed your child so that he/she will get all the macro and micronutrients according to RNI's.

Doesn't quite have the same ring to it.

The idea was to simplify and I personally don't believe I simplified things to the point of inducing nutrient deficiencies in those children whose parents loosely follow them. I also happen to believe that by using those basics as a springboard - children will probably be eating better than 90% of the North American population.

It's also interesting that you can flatly state that the recommendations do not meet requirements for fulfilling nutrient levels. The guidelines are too broad to make such a conclusion. Perhaps I will post about some more specific and far-reaching guidelines that will help give parents more ideas. I thought about doing so, but then thought it might be a little daunting. I think you could meet the guidelines if you were to include enough food and enough variety in the different categories.

In your first post, you mentioned not meeting requirements for:

Amino Acids: How so? Meat has a complete amino acid profile as does milk.

EFA's: Probably worth mentioning to include fish a couple of times per week to help get omega-3's, although if children eat seeds, nuts, greens and consume oil of some sort (which they invariably will throughout the week in most households) there shouldn't be a problem there. Moreover - I think we'll agree that children would have no problem meeting omega-6 requirements.

Micronutrients: By getting a good variety, I don't think these basic guidelines will fall drastically short on any particular micro.

Speaking of deficiencies, you curiously use the word "malnutrition" when describing (again) the basic guidelines. Perhaps your definition of malnourishment differs from mine, but that's a term I reserve for children who are severely deficient to a point where their lives are at risk. So again, falling short here and there on certain vitamins and minerals does not a malnourished kid make.

Also regarding deficiencies, I guess it doesn't surprise me that studies have shown some shortcoming with respect to certain vitamins and minerals. The question is, do these studies in any way show or suggest that children are suffering dire consequences because of it? I think you'll agree that there are variations of deficiency and a threashold if you will when children will deleterious effects will present themselves. Did the stuides show exactly how many children were severely deficient vs. a little deficinet? That would be an important finding - not so much that some children ARE deficient.

My point here was that I don't see many north American children with;
Scurvy (Vitamin C deficiency)
Rickets (vitamin D deficiency)
Red blood cell damage, nerve destruction (vitamin E deficiency)
Blindness, poor growth, skin disorders, respiratory infections (Vitamin A deficiency)
Anemia, brittle hair, difficulty swallowing (iron deficiency).

Interesting note here, according to the CDC, NHANES and the Pediatric Nutrition Surveillance System, iron deficiency anemia is on the decline and has been since the 70's. You mentioned that stats showed iron deficiency is found in 6-18% of children under 12. First off - my recommendations were not for those under 12, and secondly, the iron deficiency anemia rates at 7% (1-2), 5% (2-3: the age group in question) and 4% (6-11).

You also failed to mention that iron deficiency is far more common in those in the lower socioeconomic brackets. Poverty is a significant factor when it comes to deficiencies.

On we go...

Rapid heart beat, insomnia, irritable bowel syndrome, pulmonary disorders (Magnesium deficiency)

As for potassium, you mentioned in one sentence we were deficient and the next you said it was a minor shorfall. Which is it?

Oh, and I'm not terribly worried about a small percentage falling a little short on copper and zinc.

Bottom line: Don't stress out about getting 100% of the RNI's everyday. Offer good, wholesome, nutrient-dense foods with some diligence and your child should be just fine.

Mike H.

In terms of getting the recommended nutrients in my BASIC outline - I think you can do it.

Calories: Your child will eat until he/she is full. Offer them more if they are hungry, don't force the issue if they are not. They'll probably be okay.

Macronutrients (see previous post).

Vitamins:

Vitamin C: Berries, citrus fruits, green veggies - covered in the BASIC recommendations

Vitamin A: Milk/other dairy, orange, green and yellow fruits and veggies - covered.

Vitamin D: Sunshine, dairy, eggs, greens - covered.

Vitamin E: Green leafies, legumes, fortified cereals, whole grains - covered. If in doubt, sprinkle some wheat germ on your toddler's cereal

Minerals:

Iron: Eggs, meat, poultry, green leafies, whole grains, legumes - covered.

Magnesium: Dairy, meat, apples, bananas, avocadoes - covered.

Selenium: meat, grains, dairy, whole grains - covered.

Thing is Regina, because the recommendations are so broad, you could make an argument for or against them, depending on your point of view. I would guess that you'll argue that the amounts in the guidelines will not add up. Perhaps you would be correct. And if the guidelines were static and absolute, that would matter, but they are not. You would also have to convince me that IF in fact these guidelines fall short, that it would prevent proper growth and function. If you are still really concerned - give them a multivitamin.

Like I said, I may do a follow-up post on more specific guidelines that would provide a fail-safe way to meet nutrient requirements. The goal of this post, however was to give tips on how to feed your toddler. Your opinion is that it is an easy thing to do. You appear to take your childs nutrition seriously - which is a good thing. But, might you consider that it isn't easy to feed every child? What if it was meat your son didn't like? What if he was very picky? Had multiple allergies and sensitivities?

You know what? I think he'd still come out alright. Don't you?

Mike H.

I also want to add that diets vary from day to day. Some days children will get less than 50% of the RNI's for various micronutrients and some days they'll get 125%. Worrying about this from day to day isn't worth it, IMO - provided they are eating wholesome, vaired foods.

Judy

I just got back from my kids' well-child check-ups. My 2 yo, who is still nursing and has never been a huge eater, was slightly (very slightly) anemic, and I was told to limit the milks (he doesn't drink much cow's milk at all, and really doesn't eat much cheese or yogurt either) and push the food. And then I see this, to make me feel like even more of a failure. (Kidding, of course.)

We try to do all of these things. My mom is here visiting right now, which makes it really hard, as she would live off refined carbs, and I sometimes think she does, and so the boys want to have what she's having (another Reese's Peanut Butter Cup anybody?). Otherwise, though, they do eat TONS of fruit, but also whole grains, beans, nut butters, and as many veggies as I can get them to eat. They don't see us eating junk (very often) so they don't want it. The worst foods they eat - they both love Cheetos - are reserved as treats for "road trips" and traveling, which can be a godsend when you have to make a 6 hour (or longer) car trip with two young boys!

Spectra

I think a lot of people seem to think that toddlers/little kids are incapable or entirely unwilling to eat real food. When I babysit my friends' kids, they pack chicken nuggets and french fries and tell me that "that's all they'll eat". Well, yeah, if that's all you give them it is. I believe that kids will eat just about anything if you give it to them often enough and when they're young enough to acquire a good taste for it. My mom often pureed veggies like carrots, green beans, peas, broccoli, etc. and fed that to us when we were really little and as we grew up, we ate the whole versions of them...my dad was always very creative about getting us to eat our veggies. He gave us broccoli ("trees") and ranch dressing to dip them in ("snow") and we all grew to love it. We always had plenty of healthy snacks on hand to snack on: yogurts, fruit, veggies, raisins, cheese, etc. We very rarely ate mac and cheese or other "kid" foods, mostly when we went to other peoples' houses who thought we wouldn't eat "real" food.

soozeequeue

We ate macaroni a fair amount - my mom's version, which was macaroni in tomato sauce, with some real cheddar grated into it. We were enamoured with the kd boxed stuff other kids got, for a while, but then we ended up feeling sorry for them. Macaroni in tomato sauce is still the go-to comfort food for my sister and I, and now we have the whole grain pasta. It's become a favorite of my kids too - like me they had a brief flirtation with kd at their babysitters but fortunately they got over it. Kids seem to have flirtations with convenience foods but I often find if they've tried the real, homemade version that's what they return to.

FatLossBS

My son eats incredibly well for a 1 year old, consisting of mostly fruits & veggies because thats how we raised him...

Funny thing is, he won't eat any candy or anything with sugar in it, lol.

Jade

The ten tips for Setting your Toddler up for Eating Success sounds great. However, it doesn't really work to my 4 year old son. I have no problem for my second son who is two and half years. I think eating success is not on parents' effort, but a "grace" from God.

soozeequeue

Yes, there are some horses that you can lead to the water, provide great water, but you just cannot make them drink!

That said I do agree with Spectra and think we give up too easily. I have seen a lot of parents cater to their kids poor eating habits. (Had a friend who told me her kid only liked white food, you can imagine how many nutrients white-coloured food packs - and that's mostly what he got. Now she's worried because he's overweight.)

My kids are no longer toddlers and they eat a wide variety of foods, because they always were provided with a range of choices - and given enough time they eventually tried something and sometimes they liked it. And sometimes they didn't like it but did the next week.

Here is a tip to get your kids to eat a range of vegetables. Sometimes it's hard to know what to cook. One just likes carrots, one just like green beans - now I never serve a single vegetable in a dish. I always mix many colors and types of fresh frozen vegetables and steam them in the microwave - so the guy who likes carrots has his carrots in there but he might try green beans and broccoli and some peas...and eventually he might decide he likes more than carrots. Nobody ever tells me they "can't" eat the veggies that way - I wish I had thought of this earlier.

I do a little of the sneaky blending of foods they say they don't like, but only in certain situations. For instance, I want leeks in the soup and I know if they see them they wont eat them - so I cook them and blend them up then put them in the soup. I also make sure to tell them later - you just ate leeks, and you liked it!!

Spectra

My parents used the "sneak it in" technique a lot, actually. My dad would sneak broccoli and stuff into mac and cheese to make it healthy, or he'd make mini-pizzas for us with mushrooms and sliced peppers on them. Whenever we ate it and liked it, he would tell us "So you DO like mushrooms! I knew it all along". And then we'd assume that we'd always liked them and we'd keep eating them. Of course, there were some foods that my dad just couldn't get us to eat. I NEVER ate fish, even though my poor dad tried making it probably every way possible to get me to like it. I still don't care for it much, but I try to eat tuna or salmon (which I find tolerable) when I can.

soozeequeue

Son # 2 sat at our dinner table the other night, and after happily eating for about 3 minutes, took a closer inspection of his meal and said accusingly "there are onions in this!!" And his brother told him, "you can't even taste them! You can hardly see them! Just forget about it and eat it!" And - he did.

Had it been a month earlier, the brother would have balked at the onions. This is progress. Big progress.

soozeequeue

ps - when they were toddlers, they both ate onions. One of them used to ask for raw green onions on a regular basis. So even if you can get them to eat stuff as toddlers, it's no guarantee that they will keep eating it.

Heather

I need you to talk to my husband to convince him that it is a good idea to keep offering a small child something even if he "doesn't like" it.

My parents gave me lots of veggies and I like most vegetables. His mom gave him a lot of convenience food (she was a single working mother) and he only likes certain veggies, but still insists it couldn't have been any different because he just doesn't like some things and you can't make a kid like something. Hmm. :)

soozeequeue

Heather, the only vegetables I ate as a kid, besides some basic raw stuff (celery, lettuce, tomatoes, cucumbers, radishes) were peas, green beans and carrots. And potatoes, I would have lived on them if I could. I didn't like much meat - ground beef and chicken maybe. All 3 of us kids were sort of that way. My mom kept cooking other vegetables for her and dad - asparagus, broccoli, mushrooms, cauliflower (prairie Canada in the 60's and 70's, that's about as exotic as it got). - We knew we were free to try "mom and dad's vegetables" if wanted but it was was never pushed, it was just there. It took a long time for me to try some of them - up to 18 years in some cases! but now I can't think of a vegetable I don't like. Ok, brussel sprouts. But that's all.

With my kids I do the same thing but I also do the - "try one taste, you don't have to eat it if you don't like it" - but that's because my kids are willing to at least try.

So I don't think there's anything wrong from having a wide range of vegetables available. After all, you like them, so you deserve to have them on the table! The familiarity with the veg. alone might encourage a child to try it.

Also, I think because we had our own garden I was willing to eat everything we grew because I had eaten it fresh - standing in the garden wiping the dirt off on my jeans! And having good stuff makes a difference to kids. My kids eat a lot of carrots because the farmers market has great organic ones that are super sweet and crispy. I can't pawn off supermarket carrots or those horrible bagged carrots on them, they know!

Spectra

Having a garden is great for getting kids to eat veggies and fruits. We had a big garden and every year, we helped Dad pick seeds out (one year, I insisted that we grow Armenian cucumbers), helped weed it and we LOVED to eat the stuff we got out of it. I fondly remember picking green beans for dinner with my sis and eating most of them while we were picking them. And my mom tells me that when I was about 2, I would grab tomatoes off the vines and eat them like apples. Kids really like to eat what they grow or cook...I think getting kids to help cook with you or help you with the garden helps get them to want to try new produce.

Another thing that is cool to do with kids: At the store, let them pick a new fruit to try each week. Maybe one week they want to try a starfruit or a kiwi or a mango. Buy one and act like it's a really special treat for them...they'll try the fruit and maybe they'll love it. I remember my dad doing this with us when we were kids and we loved it...it was better than getting candy because we literally COULDN'T WAIT to try pomegranate or blood oranges or papaya. And now my sis's favorite fruit to this day is a good pomegranate and I absolutely LOVE fresh papaya.

soozeequeue

Gardens are the greatest. The kids used to help me with picking out seeds and planting too. We don't have a garden anymore because we spend our summer at our place on the lake, but we have a great u-pick down the road that has absolutely everything that can be grown here, and it makes a great substitute. Dinner at the cabin isn't complete unless there is a heaping bowl of raw peas in the shell and baby carrots. And they have those purple beans that turn green when you cook them.

MizFit

and a guide to a healthy ADULT DIET as well!!

Regina

Since the reply columns are getting narrow, I'm replying to have a wider column space, and this is in reply to Mike, who included this in the article:

Here are some guidelines for keeping pre-schoolers well nourished:

Basic Recommendations

2-3 Cups of milk products (or high calcium alternative): In addition to milk, this may include yogurt (2%+ Fat), cheese or cottage cheese.

4 Servings of Fruits and Vegetables: 1 Tablespoon serving per age is the recommended helping here. Go for a variety of color (leafy greens, peppers, tomatoes, apples, oranges, kiwis).

4 servings of bread and cereal: Whole grain cereal, bread and pasta are good choices. A serving size is about 1/4 to 1/3 an adult portion. e.g 1/4 slice toast, 1/4 cup pasta

2 servings of meat, beans, eggs, tofu: A good serving of protein should be fed at every meal. One serving equals 1/2 ounce.

------------------

On-the-fly menu for a three year old using the above "basic recommendations"....and we'll pretend the three year old is an average boy, 38" tall and 33-pounds, so he's dead center of BMI for age at 51st percentile....I'm using this number to calculate protein/amino acids.

Serving of fruits/vegetables at 1-tbs per age (3-tbs) and bread/cereal being the higher 1/3 adult portion (the 1/4 portion size creates an even worse calorie intake - see below)...and all foods being wholesome and a menu rather than just a list of foods:

Breakfast

1/2-cup 2% milk
1/3-cup whole grain cereal [Team Cheerios input]

Snack

3-tbs blueberries
1/2-cup 2% cottage cheese

Lunch

2/3-slice whole grain bread [generous cutting off of crust to only be 2/3 of a slice]
1-tbs peanut butter
1/3-cup baby carrots
1/2-cup 2% milk

Snack

1/3-cup apple slices (with skin)
1/2-cup 2% milk

Dinner

1/2-ounce roasted chicken breast
1/3-cup broccoli florets (cooked)
1/3-cup brown rice
1-cup 2% milk

The IOM considers adequate intake to be 97-98% of the DRI for essential nutrients.

The above has just the basic guideline recommendations and fails to meet the following requirements:

Energy = 759

This falls short of even the most conservative estimates (1000-1400 calories per day) for energy requirements for a three year old. Various other combinations I ran ranged between 622-calories and 759-calories (this one was the highest calorie level of menus considered, thus the one posted - it also did best for micronutrient intakes, but was still deficient for some - see below).

So - first macronutrients - if we're looking at the DRI's established by the IOM, then it falls short for both carbohydrate and fiber (although I personally hold to the previous level of fiber of 14g for this age group, getting more than that can be difficult and the published data does not support the higher recommendation in the newest release of 19g per day)

Carbohydrate = 86g
Fiber = 8g

Both omega-3 and omega-6 are absolutely not met because the DRI for LA is 7g per day and ALA is 0.7g, so 7.7g of polyunsaturated fats would be necessary (and all would need to be the EFA's, which is impossible) and the above provides only 4g total for PUFA's.

I think part of the problem with the above "basic recommendation" is that it makes an assumption about fats/oils rather than to provide any hint added fat may be needed, why, where and what type is good to consider. Because you included no specific advice regarding fats/oils, I didn't add any since it does not appear one would need to based on what you wrote.

Even if a parent were to run the menu through a calculator, they'd find 31% of the calories from fat, so could be led to think all was fine, it wasn't low in fat.

Protein was fine above, however, you said in your reply "Amino Acids: How so? Meat has a complete amino acid profile as does milk."

This is assuming all parents are going to provide adequate dairy and/or animal proteins, or are well aware of how to combine different plant proteins to meet requirements each day for amino acids if they do not provide animal sources of protein.

If you're going to make a recommendation, I think it's very important to note how to meet EAA requirements using alternatives if one is inclined to exclude (or needs to due to allergy or intolerance) dairy or animal protein sources, and also note how to meet B-12 requirements.

Moving on....micronutrient vitamins, minerals, trace elements that were not met based on the 97-98% of DRI standard:

Potassium = 1.6g of the 3.3g needed (48% of DRI)
Iron = 4.2mg of the 7mg needed (60% of DRI)
Vitamin E = 4.2mg of the 6mg needed (70% of DRI)
Choline = 150mg of the 1000mg needed (15% of DRI)

Since I don't have access to the full software (on another computer) that would allow me to calculate chromium, iodine, molybdenum, chloride, pantoethnic acid and biotin, I can't say one way or the other if any of those were missed.

Mike, you said "Micronutrients: By getting a good variety, I don't think these basic guidelines will fall drastically short on any particular micro."

Mike, realize the above menu was the best for micronutrient intake of the seven I cobbled together with different combinations and variations of foods and it still missed critical micronutrients. If a parent somehow fed their child according to the above and somehow managed my seven menus - they'd have a week of deficiency.....some people really do take the things we all write quite literally and the above leaves open the possibility that a parent would think the above is more than enough food for their kid when it's clearly not based on your suggested serving sizes and absence of any inclusion of added fats/oils.

I have to wonder - how would you improve the above menu to overcome the shortfalls noted above? Would you change the basic recommendations or add to them additional information? Or do you consider those missed micronutrients above not to be anything to be concerned with?

I don't reserve the term to something I define, but consider the UNICEF definition appropriate..."Malnutrition is a broad term commonly used as an alternative to undernutrition but technically it also refers to overnutrition. People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too many calories (overnutrition)."

No matter how I played with food options in seven menus, none met the lowest calorie intake I've seen recommended for a 3-year old - 1000-calories....thus, my use of malnutrition appears appropriate here.

Toddler Food: A Guide to a Healthy Preschool Diet

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