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N for Kids
 utrition
 A “Get Healthy” Approach
 to Achieving Weight Goals




THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE
Weigh ing In
      Parents know that the road to lifelong

      good health starts with healthy eating
                                                                  on Health
      and plenty of exercise. Getting kids and       People who maintain a healthy weight throughout life
      families started down this path is easy        stay well and live longer than those who are overweight.
      with a little assistance. In this guide, you   The lifestyle habits that help keep us slim—exercise and a
      will find the tools you and your fam-
                                                     healthy diet—also cut our risk of diabetes, heart disease,
                                                     high blood pressure, and some cancers.
      ily need to achieve many of your health

      goals: up-to-date health and nutrition            The prevalence of obesity among         spectively). One-fourth to one-third of
                                                     our nation’s youth has more than dou-      dieting adolescents practice unhealthy
      information, advice on changing habits,        bled in the past 20 years, with close to   or even dangerous diets.3 In a study of
                                                     5 million youths aged 6 to 17 seriously    5- to 12-year-olds, 45 percent of the
      tips to get your family started, and plenty    overweight or obese. The concerns          girls and 20 percent of the boys re-
                                                     caused by overweight are more than         ported having been on a diet.4 Cutting
      of delicious recipes.
                                                     a cosmetic issue. Childhood obesity        calories dramatically is often effective
                                                     leads to a variety of health problems,     at lowering weight for the short term,
                                                     such as type 2 diabetes, high blood        but this usually results in overeating
                                                     pressure, and heart disease.1 The Cen-     or binge eating and regaining of any
                                                     ters for Disease Control and Preven-       lost weight. High-protein, low-carbo-
                                                     tion recently found that 60 percent of     hydrate, and very-low calorie diets are
                                                     overweight 5- to 10-year-olds already      not safe for children or teens.
                                                     have at least one risk factor for heart       Instead, children (and adults) mere-
                                                     disease, such as raised blood pressure     ly need to switch to healthy foods.
                                                     or insulin levels.2                        When the diet is built from fruits, veg-
                                                        Many adolescent boys and girls in       etables, grains, and legumes, weight
                                                     the United States are currently trying     management is much easier, and put-
                                                     to lose weight (36 and 44 percent, re-     ting limits on calories is unnecessary.



II   NUTRITION FOR KIDS   •   PCRM                                                                       NUTRITION FOR KIDS   •   PCRM   1
For example, a veggie burger has 0.5       calories). It’s easy to make the switch     change their food intake because of         Choosing lower-fat recipes
grams of fat, saving 20 grams of fat and   and well worth the time.                    concerns about health, body size, or
180 calories (compared to hamburger            The bottom line is that it is always    personal beliefs, they focus too nar-       and foods and eating a
at 21 grams of fat and 444 calories). A    the right time to adopt a healthful diet.   rowly on just a small number of foods.
homemade bean burrito with lettuce,        It is important to help all children, re-   Exploring the broad range of health-        variety of colors are good
tomato, and salsa has 2 grams of fat,      gardless of body size, choose a healthy     ful foods now available makes a menu
saving 16 grams of fat and 135 calories    eating style and incorporate fun physi-     change fun, nutritious, and sustain-        ways to ensure that your
(compared to a fast-food chili-cheese      cal activity into their lives for now and   able.
burrito with 18 grams of fat and 390       in the future.                              • Choose low-fat, healthful options
                                                                                                                                   child’s diet is a healthy one.
                                                                                       whenever possible. Choosing lower-
                                                                                       fat recipes and foods and eating a va-
    FOOD CHOICES FOR ACHIEVING AND                                                     riety of colors are good ways to ensure
     MAINTAINING A HEALTHY WEIGHT                                                      that your child’s diet is a healthy one.
                                                                                       For example, oven-roasted potatoes
    Choosing a plant-based eating style    going hungry.”6,8 This is the key to        should be chosen over french fries,
is a simple way to achieve or maintain     lifelong weight maintenance. The sci-       pasta with marinara sauce is a better
a healthy weight because such dietary      entific evidence is clear: The closer a      option than spaghetti with meatballs,
patterns require no calorie counting       family gets to a pure vegetarian diet,      and fruit sorbet is just as refreshing
and contain the nutrients a fit body        the healthier and leaner they’ll be.        but much more healthful than ice
needs. Vegetarians have been shown to      Here are some ideas for making the          cream. The net effect is usually a re-
be leaner than their meat-eating peers                                                 duction that isn’t easily detected in the
                                           switch:
in a number of scientific studies,5,6 and                                               number of calories and fat consumed
vegetarian diets have also been shown      • Identify three or four vegetarian
                                                                                       in any given portion of food. Plus, the
to be effective in weight loss.7            recipes your family already enjoys.
                                                                                       introduction of new foods adjusts the
    Dr. Benjamin Spock, pediatrician,      Examples include bean burritos, pasta       taste buds and develops an apprecia-
medical researcher, and teacher, ad-       with marinara sauce, vegetable stir-        tion for good, wholesome food.
vised in his book Dr. Spock’s Baby and     fries, and vegetable soup. Next, think      • It’s best to avoid foods and bever-
Child Care that weight-loss programs       of three or four more frequently eaten      ages that have lots of calories but few
for children should be based upon          meals that can be easily adapted to be      or no nutrients, such as candy, soda,
changing the types of foods children       vegetarian. For example, chili can be       punch, cookies, and fried snack foods.
eat rather than the amount of food they    made with beans, and other favorites,       Fatty condiments like creamy salad
eat. He encouraged shifting the entire     such as sloppy joes and tacos, can be       dressings, mayonnaise, butter, and
family away from oily fried foods,         made with texturized vegetable pro-         margarine are best left off the plate.
meats, and dairy products and toward       tein.                                       Instead of centering meals around fat-
low-fat, plant-based foods: grains,        • Experiment and broaden food op-           ty meats and cheese, meals should be
pasta, vegetables, legumes, and fruit.     tions. Try new foods, recipes, and          built from the New Four Food Groups:
When this is done, he stated, “weight      places to eat to keep it interesting and    healthy grains, legumes, fruit, and
loss typically occurs without anyone       enjoyable. Sometimes, when people           vegetables.


2   NUTRITION FOR KIDS   •   PCRM                                                                                                       NUTRITION FOR KIDS   •   PCRM   3
THE NEW FOUR                          other vegetables, fresh or frozen, raw
                                                                                      SAMPLE MENUS FOR CHILDREN AND TEENS
                                            or cooked.
      FOOD GROUPS                           • One serving of vegetables equals




                                                                                      1 to 4 years old
                                                                                                           Breakfast:   Oatmeal with applesauce, calcium-fortified orange juice
   Plan menus using the New Four            1/2 cup cooked or 1 cup raw (unless                            Lunch:       Alphabet Soup*, whole-grain crackers, banana, peas, soymilk
Food Groups: whole grains, vegeta-          an amount is specified in the table on
                                                                                                           Dinner:      Baked beans, mashed sweet potatoes, braised collards, soymilk
bles, legumes, and fruit. People who        page 6).
consume diets built from these foods                                                                       Snacks:      Peach, Cheerios, soymilk
tend to have a dramatically lower in-       LEGUMES, NUTS, SEEDS,
cidence of heart disease, cancer, and                                                                      Breakfast: Whole-grain cereal with strawberries and soymilk
                                             AND NON-DAIRY MILKS




                                                                                      4 to 6 years old
stroke. Weight problems—which con-                                                                         Lunch:     Hummus sandwich on whole-wheat bread with lettuce and
                                            Legumes, nuts, seeds, and non-dairy                                       tomato, apple juice, orange wedge, carrot sticks
tribute to a host of health problems—
                                            milks are all good sources of protein,                         Dinner: Steamed tofu and spinach, Simply Delicious Winter Squash*,
    can also be brought under control
                                            iron, calcium, zinc, and B vitamins.                                      Oven Fries*, soymilk, baked apple with cinnamon
     by following the New Four Food
                                            Legumes are great sources of fiber.                             Snacks: Trail mix, graham crackers, soymilk
     Group recommendations.
                                            • Legumes include beans, such as
       WHOLE GRAINS                                                                                        Breakfast: Granola topped with soy yogurt, blueberries, and almonds;




                                                                                      7 to 12 years old
                                            pinto, navy, kidney, and garbanzo;
                                                                                                                      calcium-fortified orange juice
Build each of your meals around a           lentils; black-eyed or split peas; and
                                                                                                           Lunch:     Mushroom Barley Soup*, green salad, whole-wheat bread, pear
hearty grain dish. Grains are rich in       products made from soybeans, such as
                                                                                                           Dinner: Chili Mac*, greens beans, cucumber salad, soymilk
fiber and other complex carbohy-             tofu, veggie burgers, soy “hot dogs” or
                                                                                                           Snacks: Popcorn, figs, soy “ice cream”
drates, as well as protein, B vitamins,     sandwich slices, and tempeh, a hearty
and zinc.                                   fermented soy product that can be
                                                                                                           Breakfast: Bagel with peanut butter and banana, calcium-fortified orange juice




                                                                                      13 to 19 years old
• Whole grains include breads; hot          used in place of meat in many recipes.
                                            • One serving of legumes equals 1/2                            Lunch:     Missing Egg Sandwich*, Crispy Jicama Salad*, peach, soymilk
and cold cereals; pasta; cooked grains,
                                            cup of beans, tofu, or other item (un-                         Dinner: Bean burrito with lettuce, tomato, and guacamole; rice; baked
  such as rice and barley; and crackers.                                                                              tortilla chips and salsa; soymilk; Apple Crisp*
    • One serving equals 1/2 cup of         less specified in the table on page 6).
                                                                                                           Snacks: Hummus and crackers, Strawberry Smoothie*, Luna or Clif Bar
     pasta, grains, or cooked cereal, 3/4   • Non-dairy milks include breast
     to 1 cup of ready-to-eat cereal, 1/2   milk and soy formula for infants and                           * See delicious recipes starting on page 14
     bun or bagel, or 1 slice of bread.     toddlers and rice-, soy-, and other
                                            vegetable-based milks for children at     seed butters.                                                 that are high in vitamin C—citrus
          VEGETABLES                        least 1 year of age. Choose fortified      • One to two servings of nuts may be                          fruits, melons, and strawberries are
Vegetables are packed with vitamin          soymilk, such as Silk, Westsoy Plus,      included in a healthy diet, but they are                      all good choices.
C, beta-carotene, riboflavin, iron, cal-     Enriched VitaSoy, or Edensoy, when-       optional. One serving of nuts or nut                          • Fruits include all fruits, fresh or fro-
cium, fiber, and other nutrients.            ever possible, or use other fortified      butters equals 1 tablespoon.                                  zen, raw or cooked, and fruit juices.
• “Dark green vegetables” include           vegetable-based milks.                                                                                  • One serving equals 1/2 cup cooked
broccoli, kale, spinach, collards, turnip   • One serving of non-dairy milk                                        FRUITS                           fruit, 1/2 cup fruit juice, 1/4 cup dried
    greens, mustard greens, beet greens,    equals 1 cup.                             Fruits are rich in fiber, vitamin C,                           fruit, or 1 piece of whole fruit (unless
      bok choy, and Swiss chard.            • Nuts include whole or chopped           and beta-carotene. Be sure to include                         an amount is specified in the table on
      • “Other vegetables” refer to all     nuts, nut butters, whole seeds, and       at least one serving each day of fruits                       the following page).


4   NUTRITION FOR KIDS   •   PCRM                                                                                                                            NUTRITION FOR KIDS    •   PCRM   5
MENU PLANNING                                                            KID CLASSICS                        blend to make a smoothie. A scoop
                                                                                                                                           of fruit sorbet—found at many of the
Planning meals based on the New Four Food Groups is easy and helps ensure grow-                 Being vegetarian doesn’t mean hav-
ing kids get the important nutrients they need. Caloric needs vary from child to child.                                                    large ice cream chains or at the gro-
                                                                                                ing to give up classic kid fare. While
The following guidelines are general ones.                                                                                                 cery store—is also a refreshing treat
                                                                                                whole, unprocessed fruits, vegetables,
                                                                                                                                           on a hot summer day.
    1- to 4-Year-Olds     5- to 6-Year-Olds      7- to 12-Year-Olds     13- to 19-Year-Olds     grains, and legumes should be chosen
                                                                                                                                           • Fast Food. Burger King now offers
                                                                                                first, many of the foods children enjoy
                                                                                                                                           a terrific veggie burger. Other food
                         Whole Grains, Breads, Cereals                                          can be adapted to fit into a vegetarian
                                                                                                                                           chains, such as Subway, also offer
                                                                                                menu. Here are some tips:
        4 servings             6 servings            7 servings             10 servings                                                    vegetarian sandwiches, and Taco Bell
                                                                                                • Pizza. Try ordering pizza without        makes a bean burrito (just ask them to
                                       Vegetables                                               the cheese, and pile on the veggies. If    hold the cheese).
                                                                                                making pizza at home, top it off with
    2 to 4 tbsp dark     1/4 cup dark green        1 serving dark         2 servings dark       vegetarian meatballs or veggie pep-        KEEPING KIDS MOVING
    green vegetables         vegetables           green vegetables       green vegetables
                                                                                                peroni.                                        Fitness has four dimensions: car-
     1/4 to 1/2 cup        1/4 to 1/2 cup         3 servings other       3 servings other
                                                                                                • Hamburgers and Hot Dogs. Both            diovascular, strength, flexibility, and
    other vegetables      other vegetables           vegetables             vegetables
                                                                                                come in a wide variety of veggie ver-      body composition. Activities that get
                                                                                                sions. You can microwave them, bake        the heart pumping, such as running,
                     Legumes, Nuts, Seeds, Non-Dairy Milks
                                                                                                them, grill them, and top them with        swimming, bicycling, aerobics, and
      1/4 to 1/2 cup        1/2 to 1 cup             2 servings             3 servings          everything you traditionally enjoy,
         legumes              legumes                  legumes               legumes                                                       playing sports or outdoor neighbor-
                                                                                                even soy cheese.                           hood games, improve cardiovascular
    3 servings breast-   3 servings soymilk      3 servings soymilk       2 to 3 servings
                                                                                                • Cold Cut Sandwiches. Even the            fitness. Strength-training activities,
    milk, formula, or    or other non-dairy      or other non-dairy      soymilk or other
    non-dairy milk              milk                     milk             non-dairy milk        cold cut now has a non-meaty alterna-      such as weightlifting, push-ups, and
                                                                                                tive. Try a slice of veggie ham, veggie    sit-ups, as well as many daily tasks,
                                            Fruits                                              turkey, or veggie salami topped with       such as digging in the garden, lifting
      3/4 to                                                                                    lettuce and tomato and a thin layer        boxes, carpentry work, and so forth,
    1 1/2 cups                 1 to 2 cups           3 servings             4 servings          of mustard or vegan mayonnaise be-         improve muscular development and
                                                                                                tween slices of whole-wheat bread.         bone strength. Stretching, yoga, gym-
                              Be sure to include a source of vitamin B12, such as any typical
                              children’s multivitamin or vitamin-fortified cereals or soymilk.   • Chicken Nuggets and Buffalo               nastics, dancing, and martial arts all
                                                                                                Wings. Several companies, such as          promote flexibility.
                                                                                                Health as Wealth, offer these tradi-            A healthy body composition bal-
                                                                                                tional favorites in veggie form (look in   ances muscle and other lean tissue
                                                                                                the frozen food section of the super-      with an appropriate amount of fat tis-
                                                                                                market). Just add ketchup.                 sue for a child’s age and sex. Healthy
                                                                                                • Ice Cream. Soy ice cream is a ter-       body compositions are achieved
                                                                                                rific non-dairy alternative that comes      through a combination of an active
                                                                                                in a variety of styles and flavors. For     lifestyle and a healthy menu of grains,
                                                                                                a twist, add frozen fruit and a little     vegetables, legumes, and fruit.
                                                                                                soymilk to vanilla soy ice cream, and          Find ways to incorporate fun physi-


6   NUTRITION FOR KIDS    •   PCRM                                                                                                                  NUTRITION FOR KIDS   •   PCRM   7
HEALTHY SNACKS                                                     a healthier lifestyle. The same             LEARNING TO
                                                                                         healthy habits will benefit the rest             EAT WELL
Young children have high calorie and nutrient needs but their                         of the family as well as the overweight
stomachs are small. Teenagers also often have high energy needs                       child.                                    • Limit the quantities of highly pro-
combined with busy schedules. Keep delicious, healthy snack                              A “get-healthy” approach is a bet-     cessed foods and sugary beverages
choices on hand both at home and in the lunchbox.                                     ter choice than embarking on a low-       (otherwise known as “empty-calorie”
                                                                                      calorie diet for achieving fitness and     foods) and help children understand
SNACKING ON THE NEW FOUR FOOD GROUPS                                                  a healthy weight. The idea is to focus    reasonable portion sizes. Under most
                                                                                      on what is being eaten, not so much       circumstances, restricting the calorie
                     Whole Grains, Breads, Cereals                                    on quantity. The healthiest diet avoids   intake of children is not recommend-
    Pita chips or whole-grain crackers, Cheerios, granola, whole-grain                animal products completely and is         ed. Children continue to grow and de-
    cereal, popcorn (sprinkle with nutritional yeast), Luna or Clif bars              built from grains, legumes, vegetables,   velop into their early twenties, so they
                                                                                      and fruit. Plan menus using the New       can’t afford to shortchange nutrients.
                                    Vegetables                                        Four Food Groups (see page 4).            However, switching out the empty-
                                                                                                                                calorie foods with healthy options
    Baby carrots, celery stalks (try with peanut butter and raisins), avo-                                                      ensures growing kids get everything
    cado slices, salsa (try with pita chips)                                                             Healthy body           they need—except the excess calories!
                                                                                                          compositions          • Children and adults can benefit
                Legumes, Nuts, Seeds, Non-Dairy Milks
                                                                                                                                from learning to listen to their natural
    Hummus (try on carrots or crackers), nut butters (put on bread                                        are achieved          hunger and fullness cues, rather than
    or fruit), edamame (whole cooked soybeans), soy yogurt (sprinkle                                                            focusing on “cleaning their plates.”
    with granola)                                                                                              through a        Help children learn to pay attention to
                                                                                                                                natural internal signals to keep from
                                      Fruits                                                               combination
                                                                                                                                overeating. If a child does not want to
    Fortified orange juice, whole fruit, dried fruit, frozen grapes or                                       of an active        finish his or her meal now, the plate
    banana slices                                                                                                               can be wrapped and saved for when the
                                                                                                           lifestyle and        child is hungry later. Promising dessert
                                                                                                                                as a reward is best avoided as well, as it
cal activity into your family activities   tivity level and diets based on meat,                               a healthy        encourages overeating and makes less
daily. Kids need to be engaged in active   dairy products, and high-calorie, low-                               menu of         healthful foods seem special.
pursuits for at least an hour each day.    nutrient density foods. The first step is                                             • Teach children the value of good
                                           assessing a family’s lifestyle by look-                                grains,       nutrition. Parents, guardians, and
      ALREADY OVER-                        ing at eating patterns and activities to                                             teachers can work with children to-
     WEIGHT CHILDREN                       determine what changes are needed to                              vegetables,        ward an understanding that food is a
   Just as with slim children, it is al-   promote fitness and achieve a healthy                                                 fuel for health and fitness rather than
                                                                                                               legumes,
ways the right time to adopt a healthy     weight. The easiest and most effective                                                a comfort, friend, enemy, or boredom
diet. Keep in mind that the two main       method is for all members of the fam-                               and fruit.       reliever. Reading books to children
contributors to overweight are low ac-     ily to shift together—if possible—to                                                 that present nutrition in a fun and in-


8   NUTRITION FOR KIDS   •   PCRM                                                                                                        NUTRITION FOR KIDS    •   PCRM   9
teresting manner is also a good edu-                     of the television and grade-   • Pack a lunch. Bean and pasta sal-
                                     cational method.                                         school students watch for 29   ads, grilled tofu, burritos, and sand-
                                     • Get kids engaged in the food                          hours each week. Add to this    wiches make great lunches and are
                                     procurement and preparation pro-                       the time spent playing video     easy to pack. Last night’s leftovers are
                                     cess. Gardening; picking berries,                     games, using the Internet, do-    also a great, simple choice. Make sure
                                     apples, or other produce at you-pick                 ing homework, and eating din-      to include several healthy snacks.
                                     farms; or visiting the local farmers mar-           ner—and many kids spend a lot       • Encourage your child to request
                                     ket or fruit stand can spark an interest in      of time sitting still.                 that low-fat, vegetarian entrées be
                                     healthy foods. Invite them also to partici-    • Encouraging children to adopt a        placed on the lunch line. Demand
                                     pate in menu planning, as well as cooking.     healthy, vegetarian eating style and     for these items will encourage the
                                     Even very small children can help stir cold    teaching them to enjoy being active      food service to incorporate healthier
                                     or room temperature items, or wash pro-        are likely the most important lessons    foods into their menu cycle.
                                     duce, or pour ingredients. These simple        children can learn for their long-       • Parents can also volunteer their
                                     experiential lessons will often go a long      term health.                             time. Get involved with the PTA or
                                     way to promoting healthy eating habits.           Families can also put energy          directly with the food service. Work
                                                                                    toward helping to improve “get           with them to help them incorporate
                                               FITTING IN FUN                       healthy” opportunities for children      healthier foods. Some parents have
                                             PHYSICAL ACTIVITIES                    in schools. Many schools are under       even donated recipes or planned
                                                                                    financial pressure to downsize health     healthy snack breaks in the class-
                                                • Encourage children to play
                                                                                    and physical education programs, so      room.
                                                with other children and to do ac-
                                                                                    health-conscious families should sup-
                                              tive things with family members.                                                 STAYING CLEAR OF
                                                                                    port school districts in their efforts
                                            Most communities have locally
                                                                                    to promote wellness and physical           THE “FOOD FIGHT”
                                           organized activity programs after
                                                                                    education and to promote healthier       Children learn very early that what
                                          school, on the weekends, and during
                                                                                    lunches in the cafeteria. School lunch   they eat is important to their parents,
                                          the summer. Since gym class and team
                                                                                    programs are required to provide nu-     and they often use this knowledge to
                                     sports are not every child’s cup of tea, en-
                                                                                    tritious, low-cost meals to students;    their advantage. Parents may sit for
                                     couraging individual interests such as ice
                                                                                    parents and teachers can help school     hours at the dinner table with their
                                     skating, ballet dancing, or skateboarding
                                                                                    officials understand what options          children until they finish their last
                                     are important, too.
                                                                                    should be available for children. See    asparagus spear. Food can be used
                                     • It’s important for parents to talk with
                                                                                    www.HealthySchoolLunches.org for         as a reward, a way to exert control,
                                     children about their activity patterns.
                                                                                         more information.                   or a way to rebel. Rewarding kids for
                                     Children should be active for at least
                                     60 minutes on most days. Sedentary                                                      good grades or good behavior with
                                                                                          SURVIVING THE
                                     activities, such as TV watching and                                                     sweets can set up internal conflicts
                                                                                        SCHOOL LUNCH LINE                    about food. This is especially true if
                                     computer time, should be limited ex-
                                     cept when homework requires it. It is                  Here are some suggestions        the rewards are in opposition to cur-
                                     estimated that, on average, U.S. pre-              for improving the healthfulness      rent goals for health or body image.
                                     schoolers spend 23 hours a week in front           of foods eaten in schools:           If not dealt with early, these “food


10   NUTRITION FOR KIDS   •   PCRM                                                                                                  NUTRITION FOR KIDS   •   PCRM   11
fights” may extend into adult life      thing, calling Grandma or               FOR MORE INFORMATION, PLEASE VISIT OUR WEB SITES:
as well.                               a friend, or engaging in
   Finding a way to sidestep the       physical activities.                        PCRM’s Healthy Kids                     PCRM’s Healthy School
                                                                                     Campaign site:                         Lunch Campaign site:
“food fight” is a priority. If a        • Set clear divisions of re-
child is having trouble sticking       sponsibility. If a “food fight”             www.KidsGetHealthy.org                www.HealthySchoolLunches.org
to healthful foods, the following      develops, parents should define               Our main site for general                 Our Strong Bones site for
strategies may be helpful.             responsibilities around foods. The          information about healthy                information on building and
• Stock the kitchen with healthy       parent is responsible for provid-           eating and our campaigns:                   keeping healthy bones:
foods. Having plenty of fruits, veg-   ing appropriate food choices. The                www.pcrm.org                           www.StrongBones.org
etables, grains, and beans on hand     child is responsible for choosing
and keeping unhealthful foods out      what to eat among the choices of-              The PCRM Marketplace Online for information on our book,
                                       fered.                                        Healthy Eating for Life for Children, John Wiley & Sons, 2002 at:
of the house are simple ways to
eliminate conflict over which type      • Allow for healthy treats. Fresh-                               pcrm.safeshopper.com
of food to prepare or eat.             fruit smoothies, a colorful cup of
• Focus on food as a fuel for          berries in season, or a vegetable
health. Choosing a simple, health-     dish prepared a favorite way can
                                       all be special treats and prevent a                   When children                       REFERENCES
giving way of eating like the one
suggested in these pages and ex-       family from feeling deprived.                    eat healthful foods           1. Vanhalla M. Childhood weight and metabolic syn-
                                                                                                                      drome in adults. Ann Med 1999;31:236-9.
plaining to children why it is im-
portant to eat this way will help
                                         STICKING WITH IT                               and stay physically
                                                                                                                      2. Centers for Disease Control and Prevention.
                                                                                                                      CDC Surveillance Summaries, July 7, 2000. MMWR
                                                                                                                      2000;49 (No. SS-6).
them to appreciate and choose             The ease with which kids transi-
                                       tion into and stick with this healthy
                                                                                        active, their bodies          3. Neumark-Stainzer D, Rock CL, Thornquist MD,
healthful foods.                                                                                                      Cheskin LJ, Neuhouser ML, Barnett MJ. Weight-con-
• Reduce the emphasis on food          dietary pattern can be positively                   find their way to           trol behaviors among adults and adolescents: associa-
                                                                                                                      tions with dietary intake. Prev Med 2000;30:381-91.
in daily life. When people solve       influenced by a variety of factors.
problems by eating or congratu-        Family support, in terms of pro-                        a healthy size         4. Neumark-Stainzer D, Hannan PJ. Weight-related
                                                                                                                      behaviors among adolescent girls and boys: results
                                       viding healthy foods and setting a                                             from a national survey. Arch Pediatr Adolesc Med
late themselves with food, the im-                                                           and shape in a           2000;154:569-77.
portance of food has gotten out of     good example, as well as education                                             5. Snowdon DA, Phillips RL. Does a vegetarian diet
control. Finding other solutions       about nutrition, are key. If your                    pleasurable and           reduce the occurrence of diabetes? Am J Publ Health
                                                                                                                      1985;75:507-12.
to problems, such as talking about     children have convictions about
them, writing about them in a jour-    the welfare of animals or reducing                  sustainable way.           6. Melby CL, Goldflies DG, Hyner GCL, Lyle RM.
                                                                                                                      Relations between vegetarian/non-vegetarian diets
nal, or taking a walk or a bike ride   the impact on the environment                                                  and blood pressure in black and white adults. Am J
                                                                                                                      Publ Health 1989;79:1283-88.
to figure out possible steps to take,   and/or have a clear understanding
                                                                                                                      7. Ornish D, Brown SE, Scherwitz LW, Billings JH,
are much healthier and more pro-       of the health value of good eating                                             et al. Can lifestyle changes reverse coronary heart
                                                                                                                      disease? The Lifestyle Heart Trial. Lancet 1990;336:
ductive. Families should become        habits, they will be more likely                                               129-33.
accustomed to using non-food           to make the switch easily and                                                  8. Spock B, Parker SJ. Dr. Spock’s Baby and Child Care.
treats as rewards, such as a warm      be able to maintain this diet, not                                             7th edition, Simon & Schuster, New York, NY, 1998.

conversation, reading, going to a      only while away from home, but
movie or the park, making some-        throughout their lives.


12   NUTRITION FOR KIDS   •   PCRM                                                                                               NUTRITION FOR KIDS          •   PCRM      13
(or larger) baking dish with baking parch-
                                 RECIPES                                                                                                                                     ment or foil.
          These recipes and more are available on the PCRM Web site.                                                                                                         • Scrub potatoes, but do not peel. Cut into
       Please visit www.pcrm.org/health/recipes for more healthy options.                                                                                                    fries or wedges. Place in a large bowl and
                                                                                                                                                                             toss with oil, paprika, and salt.
Alphabet Soup (Makes about 2 quarts)           garlic. Cook over medium high heat until
                                                                                                                                                                             • Spread potatoes in a single layer in the
2 teaspoons olive oil                          onion is soft, about 5 minutes.
                                                                                                                                                                             baking dish and bake until tender when
1 small onion, chopped                         • Add tomato juice, potato, carrot, celery,                                                                                   pierced with a fork, about 30 minutes.
2 garlic cloves, minced                        Italian herbs, and black pepper. Cover and                                                                                    Nutrition information per 1-cup serving: 130 calories; 2
1 quart tomato juice                           simmer until tender, about 20 minutes.                                                                                        g protein; 26 g carbohydrate; 2 g fat; 2 g fiber; 142 mg so-
                                                                                                                                                                             dium; calories from protein: 7%; calories from carbohy-
1 small potato, scrubbed and cut into chunks   • Add pasta, chopped greens, and kidney                                                                                       drates: 77%; calories from fats: 16%.
1 carrot, cut into chunks                      beans. Simmer until greens and pasta are
1 stalk celery, sliced, including top          tender, about 15 minutes. Extra tomato juice                   Crispy Jicama Salad (Serves 6)
                                                                                                                                                                             Missing Egg Sandwich
2 teaspoons Italian herbs                      or water may be added if a thinner soup is                     This salad is cool, crisp, and colorful.
1/8 teaspoon black pepper                      desired.                                                                                                                      (Makes 4 sandwiches)
                                                                                                              1 medium jicama, diced (about 2 cups)
1/2 cup alphabet pasta or small pasta shells   Nutrition information per 1-cup serving: 128 calories; 5                                                                      1/2 pound firm reduced-fat tofu, mashed
                                               g protein; 25 g carbohydrate; 1.5 g fat; 6 g fiber; 203 mg      1 large carrot, peeled and cut into 1-inch
1 cup finely chopped spinach, kale, or                                                                                                                                        1 green onion, finely chopped, including
                                               sodium; calories from protein: 16%; calories from carbo-       strips
collard greens                                 hydrates: 74%; calories from fats: 10%.                                                                                       green top
                                                                                                              1 red bell pepper, cut into 1-inch strips
1 15-ounce can kidney beans, including                                                                                                                                       2 tablespoons pickle relish
                                                                                                              1 small sweet onion, thinly sliced (½ cup)
liquid                                         Apple Crisp (Serves 12)                                                                                                       2 tablespoons fat-free Nayonaise
                                                                                                              2 tablespoons finely chopped cilantro
• Heat oil in a large pot and add onion and                                                                                                                                  2 teaspoons stone-ground mustard
                                               4 large tart apples                                            3 tablespoons canned, reconstituted dry or
                                                                                                                                                                             2 teaspoons soy sauce
                                               3/4 cup sugar or other sweetener, divided                      homemade vegetable broth
                                                                                                                                                                             1/4 teaspoon each: cumin, turmeric, garlic
                                               1/2 cup flour, divided                                          2 tablespoons seasoned rice vinegar
                                                                                                                                                                             powder
                                               1 teaspoon cinnamon                                            1 tablespoons lime juice
                                                                                                                                                                             12 slices whole-wheat bread
                                               1 1/2 cups rolled oats                                         1 teaspoon stone ground mustard
                                                                                                                                                                             6 lettuce leaves
                                               1/3 cup non-dairy (soy) margarine                              1/4 teaspoon salt
                                                                                                                                                                             6 tomato slices
                                                                                                              1/4 teaspoon crushed red pepper flakes
                                               • Preheat the oven to 350°F.
                                                                                                                                                                             • Combine all ingredients. Adjust season-
                                               • Peel the apples, if desired, then core and                   • Combine the jicama, carrot, bell pepper,
                                                                                                                                                                             ings if necessary. Serve on whole-wheat
                                               slice them thinly. Toss with 1/2 cup sweet-                    onion, and cilantro in a salad bowl and toss
                                                                                                                                                                             bread with lettuce and sliced tomatoes.
                                               ener, 1 tablespoon flour, and cinnamon.                         to mix. In a small bowl, mix the remaining
                                                                                                                                                                             Nutrition information per sandwich: 197 calories; 10 g
                                               Spread evenly in a 9x13-inch baking dish.                      ingredients. Pour over the vegetables and                      protein; 29 g carbohydrate; 4 g fat; 271 mg sodium; 0 mg
                                                                                                              toss to mix.                                                   cholesterol; calories from protein: 20%; calories from car-
                                               • Mix the rolled oats with the remaining                                                                                      bohydrates: 62%; calories from fats: 18%.
                                                                                                              Nutrition information per serving: 32 calories; 1 g protein;
                                               flour and sweetener. Add the Spectrum                           7 g carbohydrate; 0 g fat; 264 mg sodium; 0 mg cholesterol;
                                               Naturals Spread or soy margarine and work                      calories from protein: 13%; calories from carbohydrates:
                                                                                                              87%; calories from fats: 0%.
                                               the mixture until it is uniformly crumbly.
                                               Sprinkle evenly over the fruit.
                                               • Bake for 45 minutes, until lightly browned.                  Oven Fries (Makes 4 1-cup servings)
                                               Let stand 10 minutes before serving                            2 russet potatoes (about 1 pound)
                                               Nutrition information per serving (1/12th of crisp): 228       2 teaspoons olive oil
                                               calories; 3 g protein; 46 g carbohydrate; 5 g fat; 4 g fiber;
                                               300 mg sodium; calories from protein: 6%; calories from        1 teaspoon paprika
                                                  carbohydrates: 75%; calories from fats: 19%.                1/4 teaspoon salt
                                                                                                              • Preheat oven to 450°F. Line a 9x13-inch




14   NUTRITION FOR KIDS   •   PCRM                                                                                                                                                       NUTRITION FOR KIDS            •   PCRM      15
some supermarkets.                                           Mushroom Barley Soup
                                                • Pinto beans or black beans may be substi-                  (Makes about 3 cups)
                                                tuted for the kidney beans.
                                                                                                             2 cups plain rice milk
                                                • Substituting fresh sweet corn cut off the                   2 tablespoons barley flour
                                                cob for the canned corn takes a little more                  1 cup cooked barley
                                                time but adds a deliciously sweet flavor to                   1 4-ounce can mushrooms, including the
                                                this meal.                                                   liquid
                                                Nutrition information per serving: 275 calories; 14 g pro-
                                                tein; 52 g carbohydrate; 1 g fat; 594 mg sodium; 0 mg cho-
                                                                                                             1/4 teaspoon garlic powder
                                                lesterol; calories from protein: 20%; calories from carbo-   1/4 teaspoon salt
                                                hydrates: 77%; calories from fats: 3%.                       pinch each of dried marjoram, sage, thyme,
                                                                                                             and dill weed
                                                Simply Delicious Winter Squash                               • Place rice milk and barley flour into a
Chili Mac (Serves 6)                                                                                                                                                       Strawberry Smoothie
                                                (Makes 4 servings)                                           blender. Blend on high speed for a few sec-
Kids of all ages love this easy-to-make meal.                                                                                                                              (Makes about 2 1-cup servings)
                                                This is a great recipe for preparing                         onds. Add barley and blend on high for
8 ounces pasta spirals or macaroni              butternut squash because it’s quick, easy,                   about 10 seconds, or until barley is chopped                  1 cup frozen strawberries
1 onion, chopped                                and absolutely delicious!                                    coarse.                                                       1 cup frozen banana chunks
2–3 garlic cloves, minced                                                                                    • Add mushrooms with their liquid. Blend                      1/2–1 cup unsweetened apple juice
1 small bell pepper, diced                      1 small butternut squash (about 4 cups
                                                                                                             just enough to coarse-chop mushrooms.                         • Place all ingredients in a blender and pro-
3/4 cup textured vegetable protein              diced)
                                                1/2–1 cup water                                              • Transfer the blended mixture to a medi-                     cess on high speed until smooth, 2 to 3 min-
1 15-ounce can crushed tomatoes
                                                2 teaspoon lite soy sauce                                    um-sized saucepan and add all the remain-                     utes, stopping blender occasionally to move
1 15-ounce can kidney beans, including
                                                1 tablespoon maple syrup                                     ing ingredients. Cook over medium heat,                       unblended fruit to the center with a spatula.
liquid
                                                                                                             stirring often, for about 5 minutes, or until                 Serve immediately.
1 15-ounce can corn, including liquid           Peel the squash, then cut it in half and re-                 the soup is hot and somewhat thickened.                       Nutrition information per 1-cup serving: 121 calories; 3 g
1 tablespoon chili powder                       move the seeds. Cut the squash into 1-inch                                                                                 protein; 31 g carbohydrate; 0.4 g fat; 2 g fiber; 8 mg sodium;
                                                                                                             Nutrition information per 1-cup serving: 159 calories; 3 g
1/2 teaspoon cumin                              cubes (you should have about 4 cups).                        protein; 34 g carbohydrate; 1g fat; 299 mg sodium; calories   calories from protein: 3%; calories from carbohydrates:
                                                                                                             from protein: 8%; calories from carbohydrate: 87%; calo-      94%; calories from fats: 3%.
• Cook the pasta in boiling water until it is   • Place into a pot with the water, soy sauce,                ries from fat: 5%.
tender. Drain and rinse it under hot water,     and maple syrup.
then set it aside.                              • Cover and simmer over medium heat until
• Heat 1/2 cup of water in a large pot, then    the squash is fork tender, about 15 minutes.
add the chopped onion and garlic. Cook un-      Nutrition information per 1-cup serving: 92 calories; 2 g    Nutrition for Kids: A “Get Healthy” Approach to Achieving Weight Goals
til the onion is soft, about 3 minutes.         protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg     is published by the Physicians Committee for Responsible Medicine, 5100
                                                cholesterol; calories from protein: 9%; calories from car-
• Add the bell pepper, textured vegetable       bohydrates: 81%; calories from fats: 10%.                    Wisconsin Ave., N.W., Suite 400, Washington, DC 20016, 202-686-2210, www.
protein, crushed tomatoes, kidney beans,                                                                     KidsGetHealthy.org.
corn, spices, and an additional 1/2 cup of                                                                   Nutrition for Kids is not intended as individual medical advice. Always discuss any
water. Stir to mix, then simmer over medium                                                                  diet change with your personal physician or your son or daughter’s pediatrician.
heat, stirring occasionally, for 20 minutes.
                                                                                                             In some cases, diet changes may alter medication needs. Persons who follow a
• Add the cooked pasta and check the sea-                                                                    vegetarian diet should be sure to include a source of vitamin B12 in their daily
sonings. Add more chili powder if a spicier
                                                                                                             routine, such as fortified cereals, fortified soymilk, or any common multiple
dish is desired.
                                                                                                             vitamin.
Tips:
                                                                                                             Readers are welcome to reproduce articles from this publication for personal or
• Textured vegetable protein is made from
soybeans and is low in fat and high in pro-
                                                                                                             educational use without additional permission. Material should not be reproduced
tein. Look for it in natural food stores and                                                                 for resale without prior arrangement with the Physicians Committee for Responsible
                                                                                                             Medicine. © PCRM, 2004.


16   NUTRITION FOR KIDS    •   PCRM                                                                                                                                                    NUTRITION FOR KIDS              •   PCRM      17
18
NUTRITION FOR KIDS
  •
PCRM
                                               WWW.KIDSGETHEALTHY.ORG


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                                                                        ORGANIZATION
                                                                         US POSTAGE
                                                                           PAID
                     5100 WISCONSIN AVE., NW, SUITE 400                   PERMIT 86
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Nutriçãocrianças

  • 1. N for Kids utrition A “Get Healthy” Approach to Achieving Weight Goals THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE
  • 2. Weigh ing In Parents know that the road to lifelong good health starts with healthy eating on Health and plenty of exercise. Getting kids and People who maintain a healthy weight throughout life families started down this path is easy stay well and live longer than those who are overweight. with a little assistance. In this guide, you The lifestyle habits that help keep us slim—exercise and a will find the tools you and your fam- healthy diet—also cut our risk of diabetes, heart disease, high blood pressure, and some cancers. ily need to achieve many of your health goals: up-to-date health and nutrition The prevalence of obesity among spectively). One-fourth to one-third of our nation’s youth has more than dou- dieting adolescents practice unhealthy information, advice on changing habits, bled in the past 20 years, with close to or even dangerous diets.3 In a study of 5 million youths aged 6 to 17 seriously 5- to 12-year-olds, 45 percent of the tips to get your family started, and plenty overweight or obese. The concerns girls and 20 percent of the boys re- caused by overweight are more than ported having been on a diet.4 Cutting of delicious recipes. a cosmetic issue. Childhood obesity calories dramatically is often effective leads to a variety of health problems, at lowering weight for the short term, such as type 2 diabetes, high blood but this usually results in overeating pressure, and heart disease.1 The Cen- or binge eating and regaining of any ters for Disease Control and Preven- lost weight. High-protein, low-carbo- tion recently found that 60 percent of hydrate, and very-low calorie diets are overweight 5- to 10-year-olds already not safe for children or teens. have at least one risk factor for heart Instead, children (and adults) mere- disease, such as raised blood pressure ly need to switch to healthy foods. or insulin levels.2 When the diet is built from fruits, veg- Many adolescent boys and girls in etables, grains, and legumes, weight the United States are currently trying management is much easier, and put- to lose weight (36 and 44 percent, re- ting limits on calories is unnecessary. II NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 1
  • 3. For example, a veggie burger has 0.5 calories). It’s easy to make the switch change their food intake because of Choosing lower-fat recipes grams of fat, saving 20 grams of fat and and well worth the time. concerns about health, body size, or 180 calories (compared to hamburger The bottom line is that it is always personal beliefs, they focus too nar- and foods and eating a at 21 grams of fat and 444 calories). A the right time to adopt a healthful diet. rowly on just a small number of foods. homemade bean burrito with lettuce, It is important to help all children, re- Exploring the broad range of health- variety of colors are good tomato, and salsa has 2 grams of fat, gardless of body size, choose a healthy ful foods now available makes a menu saving 16 grams of fat and 135 calories eating style and incorporate fun physi- change fun, nutritious, and sustain- ways to ensure that your (compared to a fast-food chili-cheese cal activity into their lives for now and able. burrito with 18 grams of fat and 390 in the future. • Choose low-fat, healthful options child’s diet is a healthy one. whenever possible. Choosing lower- fat recipes and foods and eating a va- FOOD CHOICES FOR ACHIEVING AND riety of colors are good ways to ensure MAINTAINING A HEALTHY WEIGHT that your child’s diet is a healthy one. For example, oven-roasted potatoes Choosing a plant-based eating style going hungry.”6,8 This is the key to should be chosen over french fries, is a simple way to achieve or maintain lifelong weight maintenance. The sci- pasta with marinara sauce is a better a healthy weight because such dietary entific evidence is clear: The closer a option than spaghetti with meatballs, patterns require no calorie counting family gets to a pure vegetarian diet, and fruit sorbet is just as refreshing and contain the nutrients a fit body the healthier and leaner they’ll be. but much more healthful than ice needs. Vegetarians have been shown to Here are some ideas for making the cream. The net effect is usually a re- be leaner than their meat-eating peers duction that isn’t easily detected in the switch: in a number of scientific studies,5,6 and number of calories and fat consumed vegetarian diets have also been shown • Identify three or four vegetarian in any given portion of food. Plus, the to be effective in weight loss.7 recipes your family already enjoys. introduction of new foods adjusts the Dr. Benjamin Spock, pediatrician, Examples include bean burritos, pasta taste buds and develops an apprecia- medical researcher, and teacher, ad- with marinara sauce, vegetable stir- tion for good, wholesome food. vised in his book Dr. Spock’s Baby and fries, and vegetable soup. Next, think • It’s best to avoid foods and bever- Child Care that weight-loss programs of three or four more frequently eaten ages that have lots of calories but few for children should be based upon meals that can be easily adapted to be or no nutrients, such as candy, soda, changing the types of foods children vegetarian. For example, chili can be punch, cookies, and fried snack foods. eat rather than the amount of food they made with beans, and other favorites, Fatty condiments like creamy salad eat. He encouraged shifting the entire such as sloppy joes and tacos, can be dressings, mayonnaise, butter, and family away from oily fried foods, made with texturized vegetable pro- margarine are best left off the plate. meats, and dairy products and toward tein. Instead of centering meals around fat- low-fat, plant-based foods: grains, • Experiment and broaden food op- ty meats and cheese, meals should be pasta, vegetables, legumes, and fruit. tions. Try new foods, recipes, and built from the New Four Food Groups: When this is done, he stated, “weight places to eat to keep it interesting and healthy grains, legumes, fruit, and loss typically occurs without anyone enjoyable. Sometimes, when people vegetables. 2 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 3
  • 4. THE NEW FOUR other vegetables, fresh or frozen, raw SAMPLE MENUS FOR CHILDREN AND TEENS or cooked. FOOD GROUPS • One serving of vegetables equals 1 to 4 years old Breakfast: Oatmeal with applesauce, calcium-fortified orange juice Plan menus using the New Four 1/2 cup cooked or 1 cup raw (unless Lunch: Alphabet Soup*, whole-grain crackers, banana, peas, soymilk Food Groups: whole grains, vegeta- an amount is specified in the table on Dinner: Baked beans, mashed sweet potatoes, braised collards, soymilk bles, legumes, and fruit. People who page 6). consume diets built from these foods Snacks: Peach, Cheerios, soymilk tend to have a dramatically lower in- LEGUMES, NUTS, SEEDS, cidence of heart disease, cancer, and Breakfast: Whole-grain cereal with strawberries and soymilk AND NON-DAIRY MILKS 4 to 6 years old stroke. Weight problems—which con- Lunch: Hummus sandwich on whole-wheat bread with lettuce and Legumes, nuts, seeds, and non-dairy tomato, apple juice, orange wedge, carrot sticks tribute to a host of health problems— milks are all good sources of protein, Dinner: Steamed tofu and spinach, Simply Delicious Winter Squash*, can also be brought under control iron, calcium, zinc, and B vitamins. Oven Fries*, soymilk, baked apple with cinnamon by following the New Four Food Legumes are great sources of fiber. Snacks: Trail mix, graham crackers, soymilk Group recommendations. • Legumes include beans, such as WHOLE GRAINS Breakfast: Granola topped with soy yogurt, blueberries, and almonds; 7 to 12 years old pinto, navy, kidney, and garbanzo; calcium-fortified orange juice Build each of your meals around a lentils; black-eyed or split peas; and Lunch: Mushroom Barley Soup*, green salad, whole-wheat bread, pear hearty grain dish. Grains are rich in products made from soybeans, such as Dinner: Chili Mac*, greens beans, cucumber salad, soymilk fiber and other complex carbohy- tofu, veggie burgers, soy “hot dogs” or Snacks: Popcorn, figs, soy “ice cream” drates, as well as protein, B vitamins, sandwich slices, and tempeh, a hearty and zinc. fermented soy product that can be Breakfast: Bagel with peanut butter and banana, calcium-fortified orange juice 13 to 19 years old • Whole grains include breads; hot used in place of meat in many recipes. • One serving of legumes equals 1/2 Lunch: Missing Egg Sandwich*, Crispy Jicama Salad*, peach, soymilk and cold cereals; pasta; cooked grains, cup of beans, tofu, or other item (un- Dinner: Bean burrito with lettuce, tomato, and guacamole; rice; baked such as rice and barley; and crackers. tortilla chips and salsa; soymilk; Apple Crisp* • One serving equals 1/2 cup of less specified in the table on page 6). Snacks: Hummus and crackers, Strawberry Smoothie*, Luna or Clif Bar pasta, grains, or cooked cereal, 3/4 • Non-dairy milks include breast to 1 cup of ready-to-eat cereal, 1/2 milk and soy formula for infants and * See delicious recipes starting on page 14 bun or bagel, or 1 slice of bread. toddlers and rice-, soy-, and other vegetable-based milks for children at seed butters. that are high in vitamin C—citrus VEGETABLES least 1 year of age. Choose fortified • One to two servings of nuts may be fruits, melons, and strawberries are Vegetables are packed with vitamin soymilk, such as Silk, Westsoy Plus, included in a healthy diet, but they are all good choices. C, beta-carotene, riboflavin, iron, cal- Enriched VitaSoy, or Edensoy, when- optional. One serving of nuts or nut • Fruits include all fruits, fresh or fro- cium, fiber, and other nutrients. ever possible, or use other fortified butters equals 1 tablespoon. zen, raw or cooked, and fruit juices. • “Dark green vegetables” include vegetable-based milks. • One serving equals 1/2 cup cooked broccoli, kale, spinach, collards, turnip • One serving of non-dairy milk FRUITS fruit, 1/2 cup fruit juice, 1/4 cup dried greens, mustard greens, beet greens, equals 1 cup. Fruits are rich in fiber, vitamin C, fruit, or 1 piece of whole fruit (unless bok choy, and Swiss chard. • Nuts include whole or chopped and beta-carotene. Be sure to include an amount is specified in the table on • “Other vegetables” refer to all nuts, nut butters, whole seeds, and at least one serving each day of fruits the following page). 4 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 5
  • 5. MENU PLANNING KID CLASSICS blend to make a smoothie. A scoop of fruit sorbet—found at many of the Planning meals based on the New Four Food Groups is easy and helps ensure grow- Being vegetarian doesn’t mean hav- ing kids get the important nutrients they need. Caloric needs vary from child to child. large ice cream chains or at the gro- ing to give up classic kid fare. While The following guidelines are general ones. cery store—is also a refreshing treat whole, unprocessed fruits, vegetables, on a hot summer day. 1- to 4-Year-Olds 5- to 6-Year-Olds 7- to 12-Year-Olds 13- to 19-Year-Olds grains, and legumes should be chosen • Fast Food. Burger King now offers first, many of the foods children enjoy a terrific veggie burger. Other food Whole Grains, Breads, Cereals can be adapted to fit into a vegetarian chains, such as Subway, also offer menu. Here are some tips: 4 servings 6 servings 7 servings 10 servings vegetarian sandwiches, and Taco Bell • Pizza. Try ordering pizza without makes a bean burrito (just ask them to Vegetables the cheese, and pile on the veggies. If hold the cheese). making pizza at home, top it off with 2 to 4 tbsp dark 1/4 cup dark green 1 serving dark 2 servings dark vegetarian meatballs or veggie pep- KEEPING KIDS MOVING green vegetables vegetables green vegetables green vegetables peroni. Fitness has four dimensions: car- 1/4 to 1/2 cup 1/4 to 1/2 cup 3 servings other 3 servings other • Hamburgers and Hot Dogs. Both diovascular, strength, flexibility, and other vegetables other vegetables vegetables vegetables come in a wide variety of veggie ver- body composition. Activities that get sions. You can microwave them, bake the heart pumping, such as running, Legumes, Nuts, Seeds, Non-Dairy Milks them, grill them, and top them with swimming, bicycling, aerobics, and 1/4 to 1/2 cup 1/2 to 1 cup 2 servings 3 servings everything you traditionally enjoy, legumes legumes legumes legumes playing sports or outdoor neighbor- even soy cheese. hood games, improve cardiovascular 3 servings breast- 3 servings soymilk 3 servings soymilk 2 to 3 servings • Cold Cut Sandwiches. Even the fitness. Strength-training activities, milk, formula, or or other non-dairy or other non-dairy soymilk or other non-dairy milk milk milk non-dairy milk cold cut now has a non-meaty alterna- such as weightlifting, push-ups, and tive. Try a slice of veggie ham, veggie sit-ups, as well as many daily tasks, Fruits turkey, or veggie salami topped with such as digging in the garden, lifting 3/4 to lettuce and tomato and a thin layer boxes, carpentry work, and so forth, 1 1/2 cups 1 to 2 cups 3 servings 4 servings of mustard or vegan mayonnaise be- improve muscular development and tween slices of whole-wheat bread. bone strength. Stretching, yoga, gym- Be sure to include a source of vitamin B12, such as any typical children’s multivitamin or vitamin-fortified cereals or soymilk. • Chicken Nuggets and Buffalo nastics, dancing, and martial arts all Wings. Several companies, such as promote flexibility. Health as Wealth, offer these tradi- A healthy body composition bal- tional favorites in veggie form (look in ances muscle and other lean tissue the frozen food section of the super- with an appropriate amount of fat tis- market). Just add ketchup. sue for a child’s age and sex. Healthy • Ice Cream. Soy ice cream is a ter- body compositions are achieved rific non-dairy alternative that comes through a combination of an active in a variety of styles and flavors. For lifestyle and a healthy menu of grains, a twist, add frozen fruit and a little vegetables, legumes, and fruit. soymilk to vanilla soy ice cream, and Find ways to incorporate fun physi- 6 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 7
  • 6. HEALTHY SNACKS a healthier lifestyle. The same LEARNING TO healthy habits will benefit the rest EAT WELL Young children have high calorie and nutrient needs but their of the family as well as the overweight stomachs are small. Teenagers also often have high energy needs child. • Limit the quantities of highly pro- combined with busy schedules. Keep delicious, healthy snack A “get-healthy” approach is a bet- cessed foods and sugary beverages choices on hand both at home and in the lunchbox. ter choice than embarking on a low- (otherwise known as “empty-calorie” calorie diet for achieving fitness and foods) and help children understand SNACKING ON THE NEW FOUR FOOD GROUPS a healthy weight. The idea is to focus reasonable portion sizes. Under most on what is being eaten, not so much circumstances, restricting the calorie Whole Grains, Breads, Cereals on quantity. The healthiest diet avoids intake of children is not recommend- Pita chips or whole-grain crackers, Cheerios, granola, whole-grain animal products completely and is ed. Children continue to grow and de- cereal, popcorn (sprinkle with nutritional yeast), Luna or Clif bars built from grains, legumes, vegetables, velop into their early twenties, so they and fruit. Plan menus using the New can’t afford to shortchange nutrients. Vegetables Four Food Groups (see page 4). However, switching out the empty- calorie foods with healthy options Baby carrots, celery stalks (try with peanut butter and raisins), avo- ensures growing kids get everything cado slices, salsa (try with pita chips) Healthy body they need—except the excess calories! compositions • Children and adults can benefit Legumes, Nuts, Seeds, Non-Dairy Milks from learning to listen to their natural Hummus (try on carrots or crackers), nut butters (put on bread are achieved hunger and fullness cues, rather than or fruit), edamame (whole cooked soybeans), soy yogurt (sprinkle focusing on “cleaning their plates.” with granola) through a Help children learn to pay attention to natural internal signals to keep from Fruits combination overeating. If a child does not want to Fortified orange juice, whole fruit, dried fruit, frozen grapes or of an active finish his or her meal now, the plate banana slices can be wrapped and saved for when the lifestyle and child is hungry later. Promising dessert as a reward is best avoided as well, as it cal activity into your family activities tivity level and diets based on meat, a healthy encourages overeating and makes less daily. Kids need to be engaged in active dairy products, and high-calorie, low- menu of healthful foods seem special. pursuits for at least an hour each day. nutrient density foods. The first step is • Teach children the value of good assessing a family’s lifestyle by look- grains, nutrition. Parents, guardians, and ALREADY OVER- ing at eating patterns and activities to teachers can work with children to- WEIGHT CHILDREN determine what changes are needed to vegetables, ward an understanding that food is a Just as with slim children, it is al- promote fitness and achieve a healthy fuel for health and fitness rather than legumes, ways the right time to adopt a healthy weight. The easiest and most effective a comfort, friend, enemy, or boredom diet. Keep in mind that the two main method is for all members of the fam- and fruit. reliever. Reading books to children contributors to overweight are low ac- ily to shift together—if possible—to that present nutrition in a fun and in- 8 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 9
  • 7. teresting manner is also a good edu- of the television and grade- • Pack a lunch. Bean and pasta sal- cational method. school students watch for 29 ads, grilled tofu, burritos, and sand- • Get kids engaged in the food hours each week. Add to this wiches make great lunches and are procurement and preparation pro- the time spent playing video easy to pack. Last night’s leftovers are cess. Gardening; picking berries, games, using the Internet, do- also a great, simple choice. Make sure apples, or other produce at you-pick ing homework, and eating din- to include several healthy snacks. farms; or visiting the local farmers mar- ner—and many kids spend a lot • Encourage your child to request ket or fruit stand can spark an interest in of time sitting still. that low-fat, vegetarian entrées be healthy foods. Invite them also to partici- • Encouraging children to adopt a placed on the lunch line. Demand pate in menu planning, as well as cooking. healthy, vegetarian eating style and for these items will encourage the Even very small children can help stir cold teaching them to enjoy being active food service to incorporate healthier or room temperature items, or wash pro- are likely the most important lessons foods into their menu cycle. duce, or pour ingredients. These simple children can learn for their long- • Parents can also volunteer their experiential lessons will often go a long term health. time. Get involved with the PTA or way to promoting healthy eating habits. Families can also put energy directly with the food service. Work toward helping to improve “get with them to help them incorporate FITTING IN FUN healthy” opportunities for children healthier foods. Some parents have PHYSICAL ACTIVITIES in schools. Many schools are under even donated recipes or planned financial pressure to downsize health healthy snack breaks in the class- • Encourage children to play and physical education programs, so room. with other children and to do ac- health-conscious families should sup- tive things with family members. STAYING CLEAR OF port school districts in their efforts Most communities have locally to promote wellness and physical THE “FOOD FIGHT” organized activity programs after education and to promote healthier Children learn very early that what school, on the weekends, and during lunches in the cafeteria. School lunch they eat is important to their parents, the summer. Since gym class and team programs are required to provide nu- and they often use this knowledge to sports are not every child’s cup of tea, en- tritious, low-cost meals to students; their advantage. Parents may sit for couraging individual interests such as ice parents and teachers can help school hours at the dinner table with their skating, ballet dancing, or skateboarding officials understand what options children until they finish their last are important, too. should be available for children. See asparagus spear. Food can be used • It’s important for parents to talk with www.HealthySchoolLunches.org for as a reward, a way to exert control, children about their activity patterns. more information. or a way to rebel. Rewarding kids for Children should be active for at least 60 minutes on most days. Sedentary good grades or good behavior with SURVIVING THE activities, such as TV watching and sweets can set up internal conflicts SCHOOL LUNCH LINE about food. This is especially true if computer time, should be limited ex- cept when homework requires it. It is Here are some suggestions the rewards are in opposition to cur- estimated that, on average, U.S. pre- for improving the healthfulness rent goals for health or body image. schoolers spend 23 hours a week in front of foods eaten in schools: If not dealt with early, these “food 10 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 11
  • 8. fights” may extend into adult life thing, calling Grandma or FOR MORE INFORMATION, PLEASE VISIT OUR WEB SITES: as well. a friend, or engaging in Finding a way to sidestep the physical activities. PCRM’s Healthy Kids PCRM’s Healthy School Campaign site: Lunch Campaign site: “food fight” is a priority. If a • Set clear divisions of re- child is having trouble sticking sponsibility. If a “food fight” www.KidsGetHealthy.org www.HealthySchoolLunches.org to healthful foods, the following develops, parents should define Our main site for general Our Strong Bones site for strategies may be helpful. responsibilities around foods. The information about healthy information on building and • Stock the kitchen with healthy parent is responsible for provid- eating and our campaigns: keeping healthy bones: foods. Having plenty of fruits, veg- ing appropriate food choices. The www.pcrm.org www.StrongBones.org etables, grains, and beans on hand child is responsible for choosing and keeping unhealthful foods out what to eat among the choices of- The PCRM Marketplace Online for information on our book, fered. Healthy Eating for Life for Children, John Wiley & Sons, 2002 at: of the house are simple ways to eliminate conflict over which type • Allow for healthy treats. Fresh- pcrm.safeshopper.com of food to prepare or eat. fruit smoothies, a colorful cup of • Focus on food as a fuel for berries in season, or a vegetable health. Choosing a simple, health- dish prepared a favorite way can all be special treats and prevent a When children REFERENCES giving way of eating like the one suggested in these pages and ex- family from feeling deprived. eat healthful foods 1. Vanhalla M. Childhood weight and metabolic syn- drome in adults. Ann Med 1999;31:236-9. plaining to children why it is im- portant to eat this way will help STICKING WITH IT and stay physically 2. Centers for Disease Control and Prevention. CDC Surveillance Summaries, July 7, 2000. MMWR 2000;49 (No. SS-6). them to appreciate and choose The ease with which kids transi- tion into and stick with this healthy active, their bodies 3. Neumark-Stainzer D, Rock CL, Thornquist MD, healthful foods. Cheskin LJ, Neuhouser ML, Barnett MJ. Weight-con- • Reduce the emphasis on food dietary pattern can be positively find their way to trol behaviors among adults and adolescents: associa- tions with dietary intake. Prev Med 2000;30:381-91. in daily life. When people solve influenced by a variety of factors. problems by eating or congratu- Family support, in terms of pro- a healthy size 4. Neumark-Stainzer D, Hannan PJ. Weight-related behaviors among adolescent girls and boys: results viding healthy foods and setting a from a national survey. Arch Pediatr Adolesc Med late themselves with food, the im- and shape in a 2000;154:569-77. portance of food has gotten out of good example, as well as education 5. Snowdon DA, Phillips RL. Does a vegetarian diet control. Finding other solutions about nutrition, are key. If your pleasurable and reduce the occurrence of diabetes? Am J Publ Health 1985;75:507-12. to problems, such as talking about children have convictions about them, writing about them in a jour- the welfare of animals or reducing sustainable way. 6. Melby CL, Goldflies DG, Hyner GCL, Lyle RM. Relations between vegetarian/non-vegetarian diets nal, or taking a walk or a bike ride the impact on the environment and blood pressure in black and white adults. Am J Publ Health 1989;79:1283-88. to figure out possible steps to take, and/or have a clear understanding 7. Ornish D, Brown SE, Scherwitz LW, Billings JH, are much healthier and more pro- of the health value of good eating et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336: ductive. Families should become habits, they will be more likely 129-33. accustomed to using non-food to make the switch easily and 8. Spock B, Parker SJ. Dr. Spock’s Baby and Child Care. treats as rewards, such as a warm be able to maintain this diet, not 7th edition, Simon & Schuster, New York, NY, 1998. conversation, reading, going to a only while away from home, but movie or the park, making some- throughout their lives. 12 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 13
  • 9. (or larger) baking dish with baking parch- RECIPES ment or foil. These recipes and more are available on the PCRM Web site. • Scrub potatoes, but do not peel. Cut into Please visit www.pcrm.org/health/recipes for more healthy options. fries or wedges. Place in a large bowl and toss with oil, paprika, and salt. Alphabet Soup (Makes about 2 quarts) garlic. Cook over medium high heat until • Spread potatoes in a single layer in the 2 teaspoons olive oil onion is soft, about 5 minutes. baking dish and bake until tender when 1 small onion, chopped • Add tomato juice, potato, carrot, celery, pierced with a fork, about 30 minutes. 2 garlic cloves, minced Italian herbs, and black pepper. Cover and Nutrition information per 1-cup serving: 130 calories; 2 1 quart tomato juice simmer until tender, about 20 minutes. g protein; 26 g carbohydrate; 2 g fat; 2 g fiber; 142 mg so- dium; calories from protein: 7%; calories from carbohy- 1 small potato, scrubbed and cut into chunks • Add pasta, chopped greens, and kidney drates: 77%; calories from fats: 16%. 1 carrot, cut into chunks beans. Simmer until greens and pasta are 1 stalk celery, sliced, including top tender, about 15 minutes. Extra tomato juice Crispy Jicama Salad (Serves 6) Missing Egg Sandwich 2 teaspoons Italian herbs or water may be added if a thinner soup is This salad is cool, crisp, and colorful. 1/8 teaspoon black pepper desired. (Makes 4 sandwiches) 1 medium jicama, diced (about 2 cups) 1/2 cup alphabet pasta or small pasta shells Nutrition information per 1-cup serving: 128 calories; 5 1/2 pound firm reduced-fat tofu, mashed g protein; 25 g carbohydrate; 1.5 g fat; 6 g fiber; 203 mg 1 large carrot, peeled and cut into 1-inch 1 cup finely chopped spinach, kale, or 1 green onion, finely chopped, including sodium; calories from protein: 16%; calories from carbo- strips collard greens hydrates: 74%; calories from fats: 10%. green top 1 red bell pepper, cut into 1-inch strips 1 15-ounce can kidney beans, including 2 tablespoons pickle relish 1 small sweet onion, thinly sliced (½ cup) liquid Apple Crisp (Serves 12) 2 tablespoons fat-free Nayonaise 2 tablespoons finely chopped cilantro • Heat oil in a large pot and add onion and 2 teaspoons stone-ground mustard 4 large tart apples 3 tablespoons canned, reconstituted dry or 2 teaspoons soy sauce 3/4 cup sugar or other sweetener, divided homemade vegetable broth 1/4 teaspoon each: cumin, turmeric, garlic 1/2 cup flour, divided 2 tablespoons seasoned rice vinegar powder 1 teaspoon cinnamon 1 tablespoons lime juice 12 slices whole-wheat bread 1 1/2 cups rolled oats 1 teaspoon stone ground mustard 6 lettuce leaves 1/3 cup non-dairy (soy) margarine 1/4 teaspoon salt 6 tomato slices 1/4 teaspoon crushed red pepper flakes • Preheat the oven to 350°F. • Combine all ingredients. Adjust season- • Peel the apples, if desired, then core and • Combine the jicama, carrot, bell pepper, ings if necessary. Serve on whole-wheat slice them thinly. Toss with 1/2 cup sweet- onion, and cilantro in a salad bowl and toss bread with lettuce and sliced tomatoes. ener, 1 tablespoon flour, and cinnamon. to mix. In a small bowl, mix the remaining Nutrition information per sandwich: 197 calories; 10 g Spread evenly in a 9x13-inch baking dish. ingredients. Pour over the vegetables and protein; 29 g carbohydrate; 4 g fat; 271 mg sodium; 0 mg toss to mix. cholesterol; calories from protein: 20%; calories from car- • Mix the rolled oats with the remaining bohydrates: 62%; calories from fats: 18%. Nutrition information per serving: 32 calories; 1 g protein; flour and sweetener. Add the Spectrum 7 g carbohydrate; 0 g fat; 264 mg sodium; 0 mg cholesterol; Naturals Spread or soy margarine and work calories from protein: 13%; calories from carbohydrates: 87%; calories from fats: 0%. the mixture until it is uniformly crumbly. Sprinkle evenly over the fruit. • Bake for 45 minutes, until lightly browned. Oven Fries (Makes 4 1-cup servings) Let stand 10 minutes before serving 2 russet potatoes (about 1 pound) Nutrition information per serving (1/12th of crisp): 228 2 teaspoons olive oil calories; 3 g protein; 46 g carbohydrate; 5 g fat; 4 g fiber; 300 mg sodium; calories from protein: 6%; calories from 1 teaspoon paprika carbohydrates: 75%; calories from fats: 19%. 1/4 teaspoon salt • Preheat oven to 450°F. Line a 9x13-inch 14 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 15
  • 10. some supermarkets. Mushroom Barley Soup • Pinto beans or black beans may be substi- (Makes about 3 cups) tuted for the kidney beans. 2 cups plain rice milk • Substituting fresh sweet corn cut off the 2 tablespoons barley flour cob for the canned corn takes a little more 1 cup cooked barley time but adds a deliciously sweet flavor to 1 4-ounce can mushrooms, including the this meal. liquid Nutrition information per serving: 275 calories; 14 g pro- tein; 52 g carbohydrate; 1 g fat; 594 mg sodium; 0 mg cho- 1/4 teaspoon garlic powder lesterol; calories from protein: 20%; calories from carbo- 1/4 teaspoon salt hydrates: 77%; calories from fats: 3%. pinch each of dried marjoram, sage, thyme, and dill weed Simply Delicious Winter Squash • Place rice milk and barley flour into a Chili Mac (Serves 6) Strawberry Smoothie (Makes 4 servings) blender. Blend on high speed for a few sec- Kids of all ages love this easy-to-make meal. (Makes about 2 1-cup servings) This is a great recipe for preparing onds. Add barley and blend on high for 8 ounces pasta spirals or macaroni butternut squash because it’s quick, easy, about 10 seconds, or until barley is chopped 1 cup frozen strawberries 1 onion, chopped and absolutely delicious! coarse. 1 cup frozen banana chunks 2–3 garlic cloves, minced • Add mushrooms with their liquid. Blend 1/2–1 cup unsweetened apple juice 1 small bell pepper, diced 1 small butternut squash (about 4 cups just enough to coarse-chop mushrooms. • Place all ingredients in a blender and pro- 3/4 cup textured vegetable protein diced) 1/2–1 cup water • Transfer the blended mixture to a medi- cess on high speed until smooth, 2 to 3 min- 1 15-ounce can crushed tomatoes 2 teaspoon lite soy sauce um-sized saucepan and add all the remain- utes, stopping blender occasionally to move 1 15-ounce can kidney beans, including 1 tablespoon maple syrup ing ingredients. Cook over medium heat, unblended fruit to the center with a spatula. liquid stirring often, for about 5 minutes, or until Serve immediately. 1 15-ounce can corn, including liquid Peel the squash, then cut it in half and re- the soup is hot and somewhat thickened. Nutrition information per 1-cup serving: 121 calories; 3 g 1 tablespoon chili powder move the seeds. Cut the squash into 1-inch protein; 31 g carbohydrate; 0.4 g fat; 2 g fiber; 8 mg sodium; Nutrition information per 1-cup serving: 159 calories; 3 g 1/2 teaspoon cumin cubes (you should have about 4 cups). protein; 34 g carbohydrate; 1g fat; 299 mg sodium; calories calories from protein: 3%; calories from carbohydrates: from protein: 8%; calories from carbohydrate: 87%; calo- 94%; calories from fats: 3%. • Cook the pasta in boiling water until it is • Place into a pot with the water, soy sauce, ries from fat: 5%. tender. Drain and rinse it under hot water, and maple syrup. then set it aside. • Cover and simmer over medium heat until • Heat 1/2 cup of water in a large pot, then the squash is fork tender, about 15 minutes. add the chopped onion and garlic. Cook un- Nutrition information per 1-cup serving: 92 calories; 2 g Nutrition for Kids: A “Get Healthy” Approach to Achieving Weight Goals til the onion is soft, about 3 minutes. protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg is published by the Physicians Committee for Responsible Medicine, 5100 cholesterol; calories from protein: 9%; calories from car- • Add the bell pepper, textured vegetable bohydrates: 81%; calories from fats: 10%. Wisconsin Ave., N.W., Suite 400, Washington, DC 20016, 202-686-2210, www. protein, crushed tomatoes, kidney beans, KidsGetHealthy.org. corn, spices, and an additional 1/2 cup of Nutrition for Kids is not intended as individual medical advice. Always discuss any water. Stir to mix, then simmer over medium diet change with your personal physician or your son or daughter’s pediatrician. heat, stirring occasionally, for 20 minutes. In some cases, diet changes may alter medication needs. Persons who follow a • Add the cooked pasta and check the sea- vegetarian diet should be sure to include a source of vitamin B12 in their daily sonings. Add more chili powder if a spicier routine, such as fortified cereals, fortified soymilk, or any common multiple dish is desired. vitamin. Tips: Readers are welcome to reproduce articles from this publication for personal or • Textured vegetable protein is made from soybeans and is low in fat and high in pro- educational use without additional permission. Material should not be reproduced tein. Look for it in natural food stores and for resale without prior arrangement with the Physicians Committee for Responsible Medicine. © PCRM, 2004. 16 NUTRITION FOR KIDS • PCRM NUTRITION FOR KIDS • PCRM 17
  • 11. 18 NUTRITION FOR KIDS • PCRM WWW.KIDSGETHEALTHY.ORG NON-PROFIT ORGANIZATION US POSTAGE PAID 5100 WISCONSIN AVE., NW, SUITE 400 PERMIT 86 ARDEN, NC 28704 WASHINGTON, DC 20016