Nutrient Deficiencies in Kids’ Diet

Our children’s nutrition is critical for their growth and development. They are not small adults, and often require different nutrients than adults to help support various stages of development. And as any parent knows, the task of getting your children to eat their vegetables is not always easy! This is a challenge that every parents has experienced at least some point. A question I am often asked is how do I know my kid is getting enough nutrition? How do I support a picky eater?

Unfortunately, recent research indicates children are not receiving their essential nutrients such as Vitamin A, E, C, folate, magnesium and iron (1,2). If you child is a “frequent processed food eater”, expect these number to be even lower. Particularly in terms of fiber intake. Furthermore, often when we think are children are getting the right nutrients (for example drinking adequate amounts of whole milk) they can actually be preventing their body from absorbing other nutrients. Too much milk intake is the leading cause of anemia in young children since the calcium in milk directly blocks the absorption of iron. In the last 10 years our diets have changed - and not for the better. Children are receiving significantly more sodium and chemical dyes then ever before (3).

Nutrient Needs and Portions

Calorie and portion needs change as children grow. Below is a quick reference guide to better layout children’s evolving nutrition needs. Parents’ intuition and knowledge of their child’s habits are the best gauge of a child’s daily needs.

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• For those doing dairy free, your child can receive their calcium needs from leafy greens, figs and almonds.

Fiber

• 14 g (age 1-3 years)
• 17-20 g (ages 4-8 years)
• 22-25 g (ages 9-13 years)
• 25-31 g (age 14-18 years)

Portions:

• ½ cup of fruit: ½ cup mashed, sliced, or chopped fresh fruit; ½ cup of 100% fruit juice (try watering it down 50% with ½ cup flat or sparkling water); ½ small banana, 4-5 large strawberries
• ½ cup vegetables: ½ cup mashed, sliced, or chopped vegetables; 1 cup raw, leafy greens; ½ cup vegetable juice (choose low-sodium versions); 1 small ear of corn
• 1 ounce grains: 1 slice bread; ½ cup cooked oatmeal, rice, or pasta; 1 6” tortilla
• 1 ounce protein: 1 ounce cooked meat, poultry, or seafood; 1 whole egg; 1 tablespoon peanut butter; ¼ cup cooked legumes (pinto, kidney, black beans; lentils; peas)
• ½ cup dairy: ½ cup low-fat or nonfat milk; 4 ounces low-fat, low-sugar yogurt; ¾ ounce cheese. For those doing dairy free your child can get receive their calcium needs from leafy greens, figs and almonds

What should the dinner plate look like?

What should be supplemented?

If your child is receiving the above proportions, they are receiving most of their nutrients. During some stages of growth and development the requirements make it difficult to meet with food alone. For example, in young school age children they need lots of the good fats (Omega-3) as their brains are developing. As children grow, they require Vitamin D for both their bone growth and immune system. Most children, even in the sunny state of Arizona are not receiving enough Vitamin D from the sun. Magnesium is difficult to obtain by diet alone and has so many health benefits (see supplement of the month article for details).

I still recommend giving kids Omega-3 daily, magnesium along with Vitamin D as supplements during the school-age years. Now days there are so many ways these supplements are available from fruit flavored smoothie drinks to chocolate tabs, making the daily routine of getting your kid to take their vitamins an enjoyable process.

Recommended Supplements

1. Omega-3 1000 DHA and EPA in small children, 2000 in older children

2. Magnesium (prefer citrate form) 130mg in toddlers -350 mg/day in older children

3. Vitamin D3, take 1,000 - 5,000 I.U.s daily

See link below if you are having trouble finding a specific supplement or want to see some of my recommended brands.

http://www.azkidsmd.com/service/details/dispensary

References

1. O’Neil CE et al. Food Sources of Energy and Nutrients of Public Health Concern and Nutrients to Limit with a Focus on Milk and other Dairy Foods in Children 2 to 18 Years of Age: National Health and Nutrition Examination Survey, 2011-2014s. 2018;10(8):1050.

2. Keast DR et al. Food sources of energy and nutrients among children in the United States: National Health and Nutrition Examination Survey 2003–2006. 2013;5:283–301.

3. Thorning TK et al. Whole dairy matrix or single nutrients in assessment of health effects: Current evidence and knowledge gap. 2017;105:1033–1045.

4. United States Department of Agriculture. Choose MyPlate. https://www.choosemyplate.gov. Accessed December 5, 2018.

5. Gidding SS et al and endorsed by the American Academy of Pediatrics. Dietary Recommendations for Children and Adolescents: A Guide for Practitioners. Circulation. 2005;112:2061–2075.

6. Fulgoni VL et al. Foods, fortificants, and supplements: Where do Americans get their nutrients?J2011;141(10):1847-1854