Nursery Food: Food groups - On balance

The human body requires a variety of foods to provide all the nutrients needed to grow well, stay healthy and reduce the risk of diet-related diseases. For most people, the variety of nutrients required remains the same, but the amount of each nutrient needed differs according to a person's gender and stage in life.

A useful guide to the types and proportions of food that we need to eat for a healthy and balanced diet is the eatwell plate. The plate model - tested extensively with consumers and health professionals - was produced by Public Health England in association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland. It was revised earlier this year.

The eatwell plate represents the balance of foods required in our diet generally, rather than in a specific meal or over a particular timescale. The size of each segment is consistent with Government recommendations for a diet that would provide all the nutrients required for a healthy adult or child over the age of two years.

The plate has its limitations - for example, it is hard to fathom how ready-made food products fit into the five categories - and there are some important considerations when using the plate to plan young children's diet.

Nutrient-dense food Children under the age of two have high energy needs, so foods need to be more 'nutrient dense' than for older children and adults. Therefore, some of the low-fat, high-fibre foods included on the eatwell plate are not suitable for them. But between the ages of two and five years, children can make a gradual transition towards the type of diet recommended for the rest of the family, shown in the eatwell plate.

Supplements While eating according to the eatwell plate meets the nutritional needs of most people, there are certain times in life when food alone cannot provide the nutrients needed. Therefore, the Department of Health recommends that all babies aged from six months to five years old are given supplements, in the form of vitamin drops, that contains vitamins A, C and D. Supplements are also needed when planning a pregnancy, during pregnancy and for new mothers.

MEALS AND SNACKS

Although the eatwell plate is divided into five groups, children's meals and snacks should be based on the four main groups.

1. Fruit and vegetables contain lots of vitamins, minerals and fibre. They should make up one-third of our daily diet and be included in every meal. A portion size for under-fives is 40g, while for over-fives and adults it is 80g.

It is good to introduce children to lots of different types of fruit and vegetables from an early age, whether fresh, frozen, canned in water, as juice or dried. Don't worry if they prefer one or two varieties initially; you can encourage them to try new flavours as they grow. Evidence suggests that children come to like fruit and vegetables offered regularly in small amounts and without any pressure to eat them.

2. Bread, rice, potatoes, pasta and other starchy foods provide energy, nutrients and some fibre. This group should make up one-third of our daily diet, and include a variety of at least five portions a day. As well as the foods on the eatwell plate, this includes yams, chapattis and couscous.

Wholegrain varieties are recommended for adults and older children but are not advisable for younger children because they can fill children up before they have eaten enough calories. However, foods such as wholemeal bread, pasta and brown rice can be included in young children's diet alongside white rice, white pasta and other types of bread. For active people over the age of two, higher energy needs (calories) can be met by increasing foods from this group.

3. Milk and dairy foods, or non-dairy alternatives containing the same nutrients, should be eaten daily in moderate amounts. These are a good source of calcium, for building strong bones and teeth, and vitamin A, for healthy skin and eyes and resisting infections. They are also important sources of riboflavin and iodine.

Semi-skimmed milk can be introduced from the age of two, provided a child is eating and growing well for their age. One per cent fat or skimmed milk is not recommended for under-fives as the fat content is too low. A child needs about three servings of dairy products a day, either as a drink or a milk-based product such as cheese, plain yoghurt or plain fromage frais. Choose lower-fat products for children from two years old, if they are eating well.

4. Meat, fish, eggs, beans, and other non-dairy sources of protein contain essential nutrients and iron and should be consumed in moderate amounts every day. It is recommended that children have one or two portions from this group each day.

Pulses (beans, lentils and peas) and foods made from pulses (tofu, hummus and soya mince) are excellent sources of protein and iron. Nuts also contain protein and nut butters are nutrient rich. However, whole nuts, including peanuts, should not be given to under-fives in case they choke (also, check for allergies). Try to offer children oil-rich fish once a week.

5. Foods and drinks high in fat and/or sugar are not essential for a healthy diet and their consumption should be limited.

FAT, SALT AND SUGAR

Fat, salt and sugar should be kept to a minimum in children's diets and tips on how to do this are at www.nhs.uk/Livewell/healthy-eating/Pages/Healthyeating.aspx.

Fat Children, especially under-twos, need concentrated energy provided by fat, such as that found in whole milk, yoghurt, cheese, meat and oily fish.

Sugar Limit added sugar to keep teeth healthy. Added sugars are found in fizzy and fruit juice drinks, sweets, cakes and jam as well as many other processed foods. Avoid them particularly as part of snacks.

Salt There is no need to add salt to children's food. Too much salt can give a child a taste for salty foods and contribute towards high blood pressure in later life.

The maximum daily salt intake for babies up to one year is 1g - this can only be met if no salt is added to food - 2g for children aged one to three, and 3g for children aged four to six. Check the food label if you are planning on sharing a purchased product with a mixed age group as it is likely to be too salty for babies.

IRON INTAKE

Early years settings need to pay particular attention to children's iron intake from the age of six months, when breast milk or formula milk alone can no longer provide a child's daily requirement. Iron deficiency can lead to anaemia, which can affect a child's physical and mental development.

Therefore, it is essential to introduce a good variety of iron-rich foods around six months, including meat, fish, eggs, dark green vegetables, soya beans, lentils, wholemeal cereals and dried fruit such as apricots, figs and prunes.

A good mixed diet can provide all the iron a child needs, so there is no need for fortified milk drinks. Tea should never be served as a drink to under-fives because it can prevent iron absorption from food.

MORE INFORMATION

• The updated eatwell plate and Your guide to the eatwell plate - helping you eat a healthier diet (May 2013) are at: www.gov.uk/government/publications/the-eatwell-plate-resources

• www.nhs.uk/Livewell/Goodfood/Pages/Underweightyoungchild.aspx

• www.nhs.uk/conditions/pregnancy-and-baby/pages/vitamins-for-children.aspx

• www.nhs.uk/Conditions/pregnancy-and-baby/Pages/solid-foods-weaning.aspx

UNDER-TWOS AND THE EATWELL PLATE

Breastmilk contains all the essential nutrients needed to support life and meet babies nutritional needs during the first stage of life. It also contains protective factors which are unique to each mother. Breastmilk or a first infant formula, which can provide adequate nutrition, are recommended in the first six months of life.

After that, milk alone no longer provides sufficient nutrient density for the growing baby's increasing appetite and nutritional needs, so a variety of foods from the four main food groups should be introduced to complement the main milk given.

Whole cow's milk can replace infant formula milk from age one. Mums can continue breastfeeding into the second year or switch to making cow's milk their child's main drink.

At the complementary feeding or 'weaning' stage, it is vital that children are introduced to a wide variety of foods that are relatively 'nutrient dense' (see above) as this:

• ensures a healthy and balanced diet

• replenishes iron stores

• accustoms infants to the experience and taste of different foods, especially vegetables and fruits. There is evidence that the rate at which foods are introduced from six months of infancy may affect food preference, development of speech and behaviour throughout life.

As young make the transition to a diet suitable for older children and adults, they can eat appropriate family foods from one year and should be part of family mealtimes.

Diana Hawdon is a registered nutritionist (public health) and early years project manager for Food For Life Partnership, Soil Association