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Nutrition Through The Ages: School-Age Children

Updated: May 24, 2023

School-age children have a less intense growth rate when compared to infants and toddlers; however, their growth is consistent which means children need to eat regularly and adequately to fuel their growth. Due to their constant growth and increased metabolism, the nutrient needs of children are higher in proportion to body weight compared to adults. This is why intentional nutrition throughout childhood is valuable, not only to support normal growth and cognitive development - but also to establish healthy eating patterns (like those mentioned in Toddler Feeding Practices). As always, a balanced and varied diet will likely provide sufficient nutrition.


[For the purposes of this series, ages 4 through 8 fall into this stage of life.]


Building Eating Behaviors

Many eating behaviors and food preferences (likes and dislikes) are established and/or further strengthened during childhood. Food "marketing" influences food choices and eating habits, and it occurs in many forms. Family norms, friends' preferences, media consumed (TV, internet, and social media), and various advertising sources, including the school environment and after-school events, have the ability to dictate a child's opinion. School-age children are often willing to eat a wider variety of foods than they may have previously as toddlers; but, picky behaviors may also solidify at this age. Creating a healthy environment for meals can help counter some of these behaviors.


Disordered eating is perceived to be first encountered in teens and young adults; however, it is actually THESE, young childhood years where precedent is first established. This age is when parents potentially become concerned over children's eating habits and overcompensate with feeding practices around pressure, reward, and restriction to create the desired end result. This is also when emotional eating practices tend to build, when foods are offered to comfort, calm, distract, and even shape other behaviors. Unfortunately, the result of these coercive behaviors is often the opposite of what was intended. Instead, children develop eating habits that do not allow them to recognize their own hunger and fullness cues. More on this is provided in the Body Image section below.


Diet & Academic Performance

When it comes to cognition, and academic performance, nutrition is incredibly influential. It's not just about the ability to think properly, it is deeply connected to brain development throughout life. Meal frequency, quality, and variety all have the ability to impact academic performance and overall cognition; and this means that food insecurity has an immense impact on academic performance. Research consistently indicates that adequate nutrition and regular physical activity are connected to higher reading, math, and science test scores.


The impact of diet is exactly why we've seen changes around school meal nutrition standards to include increased amounts and variety of fruits, veggies, and whole grains, while limiting high sodium, high added sugars, high saturated fats, and high calorie foods. It is also why we have seen the development of nutrition initiatives around farm to school and school gardens; wellness policies; nutrition education and promotion; and food and beverage marketing in schools.


Fun Fact: "President Harry S. Truman signed the National School Lunch Act on June 4, 1946. Though school foodservice began long before 1946, the Act authorized the National School Lunch Program (NSLP). The legislation came in response to claims that many American men had been rejected for World War II military service because of diet-related health problems. The federally assisted meal program was established as “a measure of national security, to safeguard the health and well-being of the Nation’s children and to encourage the domestic consumption of nutritious agricultural commodities.” - School Nutrition Association

 

Macronutrients

Macronutrients are the nutrients the body requires in large amounts. They are what makes up our total caloric intake.


Carbohydrates

  • NEEDED FOR: Carbohydrates are the brain’s primary choice for energy.

  • NOTE: Low-carb diets are NOT suggested for school-age children.

  • AMOUNT: 45 to 65% of total intake (adult levels)

  • FOODS TO EAT: Complex carbs (whole grains, vegetables, lentils, peas and beans), but also nutrient-rich simple carbs like fruits and 100% fruit juice.

Fats

  • NEEDED FOR: Dietary fats support normal brain development. Fat also helps cushion and insulate the body, and it supports many body processes.

  • NOTE: Fats are needed to absorb some vitamins (A, D, E, K).

  • AMOUNT: 25 to 35% of total intake (adult levels)

  • FOODS TO EAT: Unsaturated fats (avocados, peanut butter, almonds, walnuts, olive oils, peanut oils, canola oils, flax seed, and salmon).

Protein

  • NEEDED FOR: Protein is necessary for proper growth and development, especially during childhood.

  • NOTE: Milk-drinking and cheese eating children have little difficulty meeting protein needs.

  • AMOUNT: 10 to 25% of total intake (adult levels)

  • FOODS TO EAT: Lentils, nut butter, hummus, oatmeal, whole wheat products, salmon, fish sticks, eggs, turkey lunch meat, yogurt, mozzarella string cheese, and even veggies like peas, broccoli, and potatoes.

Calories

*Not a macronutrient, but worth including here.

  • NEEDED BECAUSE: Calories are the fuel our bodies require to survive.

  • NOTE: Just like adults, calorie needs for children depends on their age, size, and activity level. Generalizing caloric intake, 4 to 5 year-olds need approximately 70kcal/kg/day, 6 to 8 year-olds need 60 to 65 kcal/kg/day.

  • NUTRITION TIP: Incorporating healthy after-school snacks can be essential to total daily caloric intake as these snacks can contribute up to one-fourth of a child's total calorie intake for the day.

  • NUTRITION TIP: Growth charts are essential tools for nutrition assessments and nutrition counseling in children.

"Weight, length, weight for height, and head circumference (HC) are the primarily used markers for measuring growth rates in infants and children. Trends in growth patterns over time provide more valuable information than a single measurement." - Patel; 2021

Micronutrients

Micronutrients are the nutrients the body requires in small amounts. Although they are recommended in smaller amounts compared to macronutrients, they are equally essential.


Vitamin A

  • NEEDED FOR: Vitamin A is needed for growth and development, vision, and immunity.

  • NOTE: "Vitamin A deficiency is a major public health problem worldwide. It is the leading preventable cause of blindness among children in developing nations." - Oregon State University

Vitamin C

  • NEEDED FOR: Vitamin C is needed for growth and development, and immunity.

  • NOTE: Vitamin C is a well-known antioxidant that enhances immune functions.

  • NUTRITION TIP: Vitamin C is highly unstable. It is impacted by both oxygen exposure and heat. If the goal is retain as much Vitamin C as possible, avoid cooking veggies at high heat for long periods of time. Similarly, when exposed to oxygen, Vitamin C loses its potency. Avoid pre-peeling oranges, pre-cutting strawberries for your children. Don't let fruit juices sit out uncovered for long periods of time

Vitamin E

  • NEEDED FOR: Vitamin E, like Vitamin C, is an integral antioxidant that is essential for immune functionality.

  • NOTE: Vitamin E deficiencies are rare (thanks largely to fortified foods), and typically only show in extreme cases of malnutrition.

  • NUTRITION TIP: Greens, peanut butter, and fortified foods are great sources.

Potassium

  • NEEDED FOR: Like the others mentioned here, potassium is essential for growth and development. It is also integral for heart functionality.

  • NOTE: Potassium is a nutrient of concern for many Americans as deficiencies can occur. Potassium deficiencies in children based on diet are rare - typically the deficiency is caused by bouts of vomiting and diarrhea.

  • NUTRITION TIP: Potassium can be found in many 100% fruit and veggie juices, as well as their whole food counterparts.

Calcium

  • NEEDED FOR: Calcium promotes bone structure, which is essential at this age.

  • NOTE: Calcium-fortified orange juice, milk alternatives, supplements, etc. can replace dairy.

  • NOTE: Girls tend to consume less calcium compared to boys at this age.

  • NUTRITION TIP: Although dark green veggies are a good source of calcium, children do not consume enough of these vegetables to meet their calcium needs. Some 70% of calcium needs are met through dairy products.

Iron

  • NEEDED FOR: Iron is needed for growth and development, energy production, and wound healing.

  • NOTE: Iron deficiency anemia is the most common nutrient deficiency in children in the U.S. (and around the world) and remains significant for this age group. An iron deficiency can impact attention, cognition and energy levels.

  • NUTRITION TIP: Good sources of heme iron (animal proteins) are lean meats, fish, and poultry. Non-heme iron sources are primarily plant based (peanuts, lentils, peas, and beans, greens and fortified foods), but also include some animal proteins like egg yolks.

  • NUTRITION TIP: Vitamin C is suggested at the same meals when consuming non-heme iron sources as this will help increase absorption.

Zinc

  • NEEDED FOR: Zinc is considered to be essential for growth and development. It impacts taste and smell, and participates in wound healing.

  • NOTE: Along with Iron, Zinc needs increase in this age group as even a mild zinc deficiency can impact growth.


 

Additional Nutrition Related Considerations


Body Image

What & Why

  • Body image concerns develop much earlier than many of us think, and children mimic their role models.

  • Body sizes, shape, and weight often fluctuate at this time. This often encourages weight/size centric talk.

  • "Child-fat talk" (discussions around a child's weight) is associated with binge eating, overeating, secretive eating, and overweight/obesity in children. - Lydecker; 2018

  • A parents' use of restrictive feeding practices is not effective in limiting children's food intake, and can actually promote children's consumption of the restricted foods (even in the absence of hunger). - Fisher; 2002

  • A young child's ability to regulate energy intake can be disrupted by focusing their attention on environmental cues, including the use of food rewards and drawing attention to the amount of food remaining on their plate. - Fisher; 2002

  • Excessive control in feeding diminishes children's capacity for self-regulation. - Birch; 2000

  • Mothers who diet tend to have daughters who diet by the time they reach adolescence. - Birch; 2000

  • Parents own restrained eating style predicts child restriction behaviors. - Fisher; 1999

Tips

  • It is essential that children understand how body sizes, shape, and weight are not "universal".

  • Weight and body image concerns transfer onto your children!

  • Avoid weight centric talk.

  • Encourage physical activity and eating well-balanced, varied eating (include role modeling).

  • Avoid diet talk and food restricted behaviors.

  • Review Ellyn Satter's "What is Normal Eating?"

  • Become familiar with signs and symptoms of disordered eating.

Fiber Intake

What & Why

  • As with every other age group, fiber intake is essential to overall health and is often lacking in a child's diet.

  • Soluble fiber dissolves in water, becomes a gel-like consistency and slows down digestion so the GI tract can absorb nutrients.

  • Insoluble fiber does NOT dissolve, which allows it to work its way through our intestines, brushing and scrubbing our insides as it goes. It also provides nutrition for our gut bacteria.

  • Both types of fiber increase feelings of satiety and helps us stay satisfied longer.

Tips

  • Soluble fiber can be found in beans, oats, fruits, nuts, seeds, and veggies.

  • Insoluble fiber can be found in wheat, whole grain foods, fruits, nuts, seeds, and vegetables.

  • In children, the fiber intake goal is age + 5 grams.

  • Read the nutrition label! Foods indicate the percent daily value per serving!


Hydration

What & Why

  • 75% of children fail to meet the Daily Recommended Intake. The DRI of water depends on age, sex, weight, activity status, air temperature, and humidity. - Faizan; 2021

  • To stay well hydrated, children ages 4-8 years need approximately 5 cups of beverages per day, including water or milk.

  • Water keeps joints, bones and teeth healthy, and it helps the blood circulate. Being well hydrated improves mood, memory and attention.

Tips

  • Plain water serves as the best way to fulfill hydration needs. - Faizan; 2021

  • Ignore all the hype surrounding many of the other drinks marketed to kids. - HealthyChildren.org; 2020

  • Keep fruits and vegetables that are high in water content handy - HealthyChildren.org; 2020

  • Infuse water with lemons, berries, cucumber or mint for some added flavor. - HealthyChildren.org; 2020


Watch Companion Video Here!


Other Nutrition Through The Ages Posts!

Resources

Akubuilo, U. C., et al. “Nutritional Status of Primary School Children: Association with Intelligence Quotient and Academic Performance.” Clinical Nutrition ESPEN, vol. 40, Dec. 2020, pp. 208–13. ScienceDirect, https://doi.org/10.1016/j.clnesp.2020.09.019.


Birch, Leann L., and Jennifer O. Fisher. “Mothers’ Child-Feeding Practices Influence Daughters’ Eating and Weight.” The American Journal of Clinical Nutrition, vol. 71, no. 5, May 2000, pp. 1054–61. DOI.org (Crossref), https://doi.org/10.1093/ajcn/71.5.1054.


“Carbohydrates.” www.Heart.Org, https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/carbohydrates. Accessed 13 May 2022.


Childhood Nutrition Facts | Healthy Schools | CDC. 16 Feb. 2021, https://www.cdc.gov/healthyschools/nutrition/facts.htm.


“Children.” Linus Pauling Institute, 29 Apr. 2014, https://lpi.oregonstate.edu/mic/life-stages/children.


Children Need Carbohydrates. https://www.eatright.org/food/nutrition/dietary-guidelines-and-myplate/children-need-carbohydrates. Accessed 13 May 2022.


“Choose Water for Healthy Hydration.” HealthyChildren.Org, https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Choose-Water-for-Healthy-Hydration.aspx. Accessed 5 June 2022.


Daniels, Lynne Allison. “Feeding Practices and Parenting: A Pathway to Child Health and Family Happiness.” Annals of Nutrition and Metabolism, vol. 74, no. Suppl. 2, 2019, pp. 29–42. DOI.org (Crossref), https://doi.org/10.1159/000499145.


Faizan, Unaiza, and Audra S. Rouster. “Nutrition and Hydration Requirements In Children and Adults.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK562207/.


Fats (for Parents) - Nemours KidsHealth. https://kidshealth.org/en/parents/fat.html. Accessed 14 May 2022.


Fisher, Jennifer Orlet, and Leann L. Birch. “Eating in the Absence of Hunger and Overweight in Girls from 5 to 7 y of Age.” The American Journal of Clinical Nutrition, vol. 76, no. 1, July 2002, pp. 226–31. DOI.org (Crossref), https://doi.org/10.1093/ajcn/76.1.226.


Fisher, J. O., and L. L. Birch. “Restricting Access to Foods and Children’s Eating.” Appetite, vol. 32, no. 3, June 1999, pp. 405–19. DOI.org (Crossref), https://doi.org/10.1006/appe.1999.0231.


Growth Charts - WHO Child Growth Standards. 11 Jan. 2019, https://www.cdc.gov/growthcharts/who_charts.htm.


Hayes, Dayle, et al. “Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools.” Journal of Nutrition Education and Behavior, vol. 50, no. 5, May 2018, pp. 433-439.e1. ScienceDirect, https://doi.org/10.1016/j.jneb.2018.03.001.


History of School Lunch - ILSNA. https://www.ilsna.net/resources/schoolnutrition/historyschoollunch. Accessed 5 June 2022.


Interactive Nutrition Facts Label. https://www.accessdata.fda.gov/scripts/interactivenutritionfactslabel/vitamins.cfm. Accessed 29 Mar. 2022.



Lydecker, Janet A., et al. “Associations of Parents’ Self, Child, and Other ‘Fat Talk’ with Child Eating Behaviors and Weight.” International Journal of Eating Disorders, vol. 51, no. 6, June 2018, pp. 527–34. DOI.org (Crossref), https://doi.org/10.1002/eat.22858.


Patel JK, Rouster AS. Infant Nutrition Requirements and Options. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021. PMID: 32809593.


“Raise a Healthy Child Who Is a Joy to Feed.” Ellyn Satter Institute, https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding/. Accessed 13 May 2022.


Samuel, Tinu Mary, et al. “A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth.” Nutrients, vol. 10, no. 12, Dec. 2018, p. 1992. www.mdpi.com, https://doi.org/10.3390/nu10121992.



Thompson, Janice, et al. The Science of Nutrition. 2nd ed., Student ed, Pearson Benjamin Cummings, 2011.


Verulava, Tengiz, and Rozi Devnozashvili. “Nutrition and Academic Performance among Adolescences.” Romanian Journal of Diabetes Nutrition and Metabolic Diseases, vol. 28, no. 3, Oct. 2021, pp. 275–83. rjdnmd.org, http://rjdnmd.org/index.php/RJDNMD/article/view/1019.




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