Minerals: Calcium, Phosphorus, and Magnesium

Three minerals—calcium, phosphorus, and magnesium—account for 98% of the body’s mineral content by weight. Calcium and phosphorus play basic roles in countless biochemical reactions at the cellular level. They are also the main components of the skeleton, and without magnesium many metabolic functions could not take place.
Phosphorus is in almost all animal and vegetable foods and is often found in foods that contain calcium. Milk and dairy products, fish bones (such as in canned salmon and sardines), and dark-green, leafy vegetables are the best sources of calcium. Magnesium, like phosphorus, is abundant in animal and plant cells.
Healthy children do not lack phosphorus and magnesium because these minerals are easily absorbed. By contrast, low calcium intakes are very common, especially among adolescent girls who shun milk and dairy foods to avoid fat calories. These girls risk osteoporosis, or thinning of the bones, starting as early as age 30. Nonfat milk, yogurt, and other dairy foods are excellent sources of calcium and do not add unwanted fat calories to the diet.
Mineral absorption is influenced by a number of factors, including certain hormones and vitamin levels. Infants absorb calcium more easily than adults do, and the rate of absorption is increased when other nutrients are around, including the milk sugar lactose, the amino acids lysine and arginine, and vitamin C (eg, calcium-fortified orange juice). Calcium absorption may be decreased by high dietary levels of phosphate, oxalate (in rhubarb and certain leafy green vegetables), or phytate compounds in fiber. Too much protein in the diet may increase the amount of calcium excreted in the urine and decrease the amount available for building bones.

Making Sure Your Child is Eating Enough

As a parent, you are interested in your child's health. Your role is to provide healthy food in appropriate portions, and your child's role is to decide how much to eat. That is why it is important to understand how to provide healthy choices for your child.
Read on for information from the American Academy of Pediatrics about making healthful choices. If you have specific questions about your child's nutrition, talk with your child's doctor or a registered dietitian.

For Starters

Child-sized portions help children accept new foods. Two tips for parents include:

• Serve one-fourth to one-third of the adult portion size, or 1 measuring tablespoon of each food for each year of your child's age.
• Give less than you think your child will eat. Let your child ask for more if she is still hungry.

How do I know when my child is eating enough?

Children eat when they are hungry and usually stop when they are full. Some parents worry because young children appear to eat very small amounts of food, especially when compared with adult portions. To check your child's eating pattern, pay attention to his food choices.

• Offer all food groups at every meal. Make sure no one food group is completely left out. If this happens for a few days, don't worry. However, missing out on a food group for a long time could keep your child from getting enough nutrients.
• Encourage your child to eat a variety of foods within the food groups by modeling good eating yourself. Even within a food group, different foods provide different nutrients.
• A child who is growing well is getting enough to eat.

Building a healthy plate

Over the years, various tools have been created to provide guidance on the type and amount of food Americans should eat. MyPlate (the new healthy eating food icon that replaced MyPyramid) recommends the following:

• Balancing calories. Enjoy your food, but eat less. Avoid oversized portions.
• Foods to increase. Make half your plate fruits and vegetables. Switch to nonfat or low-fat milk (see "Milk—whole or reduced fat?").
• Foods to reduce. Compare sodium in foods like soup, bread, and frozen meals—and choose the foods with lower numbers. Drink water instead of sugary drinks.

Food groups

There is a variety of foods from each food group (the following is a sample list of food choices). The next time you go grocery shopping, try something new.
NOTE: Do not feed children younger than 4 years round, firm food unless it is chopped completely. The following foods are choking hazards: nuts and seeds; chunks of meat or cheese; hot dogs; whole grapes; fruit chunks (such as apples); popcorn; raw vegetables; hard, gooey, or sticky candy; and chewing gum. Peanut butter can be a choking hazard for children younger than 2. If your child has food allergies or is diagnosed with peanut or tree nut allergies, avoid nuts and any food that contains or is made with nut products.

Food groups	Types of foods
Grains Foods from grains are packed with starches (complex carbohydrates). Carbohydrates are the best source of energy for active, growing bodies.	Whole grains: brown rice, buckwheat, bulgur (cracked wheat), oatmeal, popcorn, whole-grain barley, whole-grain cornmeal, whole rye, whole wheat bread, whole wheat cereal flakes, whole wheat crackers, whole wheat pasta, whole wheat tortillas, wild rice Other products: mostly made from refined grains; however, some may be made from whole grains (check the ingredients for "whole grain" or "whole wheat"): cornbread, corn tortillas, couscous, crackers, flour tortillas, pasta, pitas, pretzels, ready-to-eat cereals
Vegetables Vegetables are the most important source of beta-carotene and many other vitamins and phytochemicals. Vegetables also provide plenty of fiber. Our bodies convert beta-carotene to vitamin A for healthy skin, glands, immune system, and eye function. Phytochemicals are naturally occurring plant compounds that are believed to fight cancer and other diseases. Vegetables may be fresh, canned or frozen.	Dark-green vegetables: bok choy, broccoli, collard greens, kale, spinach Red and orange vegetables: acorn, squash, butternut squash, carrots, pumpkin, red peppers, sweet potatoes, tomatoes, tomato juice Starchy vegetables: corn, green peas, lima beans, potatoes Other vegetables: artichokes, asparagus, avocado, bean sprouts, beets, brussels sprouts, cabbage, cauliflower, celery, cucumbers, eggplant, green beans, green peppers, jicama, mushrooms, okra, onions, snow peas, tomatoes, zucchini
Fruit Whole fruits provide many essential vitamins and minerals, together with a variety of disease-fighting substances like those in vegetables, and fiber. Fruits are the most important source of vitamin C. Vitamin C is needed to produce collagen, the connective substance that holds cells together and helps maintain blood vessels, bones and cartilage, and teeth.	Apples, apricots, bananas, berries (blueberries, raspberrries, strawberries), 100% fruit juices (unsweetened), grapefruit, grapes, kiwi fruit, mangoes, melons (cantaloupe, honeydew, watermelon), nectarines, oranges, papayas, peaches, pears, pineapple, plums, prunes, raisins, tangerines. Fruits may be fresh, canned, frozen, or dried. Fruits may also be whole, cut-up or pureed. NOTE: The American Academy of Pediatrics recommends that juice be limited to 4 to 6 ounces per day for children 1 to 6 years of age, and 8 to 12 ounces per day for children 7 to 18 years of age.
Protein foods    Protein is needed for growth as well as to maintain muscle, bone and cartilage, teeth, and every system in the body.	Meats: lean cuts of beef, ham, lamb, pork, and veal Poultry: skinless chicken and turkey, ground chicken and turkey Seafood: fish (catfish, cod, herring, salmon, trout, tuna); shellfish (clams, crab, lobster, mussels, oysters, scallops, squid [calamari], shrimp Beans and peas: black beans, black-eyed peas, chickpeas (garbanzo beans), kidney beans, lentils, pinto beans Processed soy products: tofu (bean curd made from soybeans), veggie burgers, tempeh, texturized vegetable protein (TVP) Nuts and seeds: almonds, cashews, peanuts, peanut butter, sunflower seeds, walnuts Eggs: chicken eggs, duck eggs
Dairy    Milk is children's best source of calcium and an important source of protein, riboflavin (vitamin B2), and many other nutrients.	Low-fat milk, yogurt, cheese (cheddar, mozzarella, Swiss, parmesan, cottage cheese), pudding, frozen yogurt, and ice milk. Calcium-fortified soymilk (soy beverage) is also part of the Dairy Group.

Source: United States Department of Agriculture http://ChooseMyPlate.gov. Accessed March 1, 2012.

Snacks count too

Snacks make up an important part of childhood nutrition and are an opportunity to encourage healthy eating. Children must eat frequently. With their small stomachs, they cannot eat enough at meals alone for their high-energy needs. Three meals and 2 or 3 healthy snacks a day help children to meet their daily nutrition needs.
To make the most of snacks, parents and caregivers should offer healthy snack choices and be consistent with the time snacks are served. Schedule snacks around normal daily events, and space them at least 2 hours before meals. Children should not feel full all the time. A feeling of hunger between meals and snacks encourages children to eat well when healthy foods are offered.

Milk—whole or reduced-fat?

The following are guidelines about what type of milk to give your child.

Age	Type of milk
Younger than 12 months	Breast milk is best; iron-fortified formula should be used if breast milk is not available.
12 to 24 months	Whole milk. Your child's doctor may recommend reduced-fat (2%) or low-fat (1%) milk if your child is obese or overweight, or if there is a family history of high cholesterol or heart disease. Check with your child's doctor or a registered dietitian before switching from whole to reduced-fat milk. Note: Breastfeeding can continue after 12 months of age as long as is desired by mom and baby.
Older than 24 months	Low-fat (1%) or nonfat (skim) milk

Is it Important to Feed Kids Organic Food?

​ The nutritional choices you make for your children are crucial, setting the stage for good health and good habits for years to come. So if you’ve heard about the benefits of organic food, you may be wondering if it’s worth the extra expense, especially if you’re on a budget.

According to the American Academy of Pediatrics, which recently weighed in on the subject of organic food for the first time, what’s most important is that children eat a variety of fruits, vegetables, lean meats, whole grains and low-fat or fat-free dairy products, whether those are conventionally or organically grown.

Organic foods do have lower levels of pesticides and drug-resistant bacteria, says Dr. Thomas K. McInerny, president of the AAP. “That may be important for kids because young children are more vulnerable to chemicals, but we simply don’t have the scientific evidence to know if the difference will affect a person’s health over a lifetime,” says McInerny.

Both organic and conventionally grown foods have the same vitamins, minerals, antioxidants, proteins, lipids and other nutrients that are important for children’s health. “If you’re on a budget, don’t buy the more expensive organic option if it’s going to reduce your family’s overall intake of healthy foods like fresh produce,” advises McInerny. “It’s better for kids to eat five servings of conventionally grown produce a day than for them to eat one serving of organic vegetables.”

Families can also be selective in choosing particular organic foods to stretch their budget. The Environmental Working Group has created a Shopper’s Guide that rates the level of pesticides in produce. Their guide indicates that conventionally grown onions, sweet corn and pineapples have relatively low pesticide rates, making them safer to purchase. If you can budget a few extra dollars to spend on groceries, opt for organic apples and celery, which are among the most pesticide-laden crops.

According to the AAP, organic milk is not healthier for kids than conventional milk, but parents should make sure all milk they purchase is pasteurized.

The jury is still out on the long-term health benefits of organic produce, but in the meantime keep your eyes and ears open for new information as it becomes available – so you can make the best possible choices in the future.

For additional nutrition tips for kids, click here.

No matter the size of your budget, you can do your kids a world of good by ensuring they get at least five servings of fruits and vegetables daily.

Lactose Intolerance in Children

I think my child might be lactose intolerant. How can I tell?

Lactose intolerance occurs in people who can't digest lactose. Lactose is the sugar found in milk. It also is found in other dairy products, such as ice cream and soft cheeses. People who are lactose intolerant don't make enough lactase. Lactase is a natural enzyme made by your intestinal tract that digests lactose. When there isn't enough lactase, lactose that is eaten isn't digested and stays in the intestines causing gas, bloating, stomach cramps, and diarrhea.

Many parents confuse the terms lactose intolerance and milk allergy. While they may share similar symptoms, they are entirely different conditions. Lactose intolerance is a digestive problem, while milk allergy involves the immune system. Your child can be tested for milk allergy or lactose intolerance.

Symptoms

Common symptoms of lactose intolerance include

• Stomach cramps
• Bloating
• Gas
• Diarrhea
• Nausea

These symptoms usually begin about 30 minutes to 2 hours after drinking or eating foods containing lactose.

How to tell

One way to check if your child has trouble digesting lactose is to take all milk products out of your child's diet for 2 weeks and see if symptoms improve. After 2 weeks, slowly reintroduce them in small amounts each day to see if symptoms return. Because many non-dairy and prepared foods contain lactose, it may be hard to remove all of these food from your child's diet.

If you think your child is lactose intolerant, talk with your pediatrician. Your child may need to be tested. The most common test for lactose intolerance is the lactose breath test. It's also called the hydrogen breath test. This test measures hydrogen levels in the breath after a lactose solution is swallowed. Normally, hydrogen is found only in low levels in a person's breath. However, when lactose isn't digested, it ferments in the intestines and produces hydrogen, which then will be exhaled through the lungs.

Your pediatrician may refer you to a specialist. If needed, a specialist can measure lactase and other enzymes from a small intestine sample. The sample usually is obtained during a diagnostic endoscopy. This procedure lets doctors view the inside of the intestines and obtain tissue samples.

What helps

There is no cure for lactose intolerance. However, if your child is lactose intolerant, diet changes can make a big difference. You can help decide what changes are best for your child.

• By trial and error. In time your child will learn, by trial and error, how much milk or milk-based foods she can handle. Younger children with lactose intolerance should avoid foods containing lactose. These foods include milk, ice cream, and soft cheeses, such as cottage cheese, American cheese, and mozzarella. Older children usually can eat small amounts of lactose-containing foods, particularly if the foods are eaten as part of a meal and not alone. Many children can keep eating yogurt and aged cheeses, such as Swiss, cheddar, and Parmesan.
• Over-the-counter lactase. Give your child over-the-counter lactase right before each meal. This may help her body digest foods that contain lactose.
• Lactose-free or lactose-reduced. Offer your child lactose-free or lactose-reduced milk and other dairy products. Lactose-reduced milk retains all the ingredients of regular milk. You can store it in the refrigerator the same length of time.

Remember

Lactose intolerance doesn't have to make your child's life miserable. There are many options for children who are lactose intolerant. Talk with your pediatrician about what products or diet changes would be best for your child.

Kids Need Fiber: Here’s Why and How

​ Fiber is an important nutrient that most children (and parents) are not getting enough of each day. As parents, you do your best to feed your family healthy foods, but you may need help with choosing good sources of fiber.

How Much Fiber Do Children Need?

There are different fiber recommendations for children based on energy needs, age, or weight.

• Eat 5. A simple way to make sure your children are getting enough fiber is by making healthful food choices. If your children are eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams.
• Add 5. If you find it helpful to keep track of numbers, add 5 to your children’s age. For example, a 5-year-old would need about 10 grams of fiber each day. Note: The total daily recommended amount of up to 25 grams for adults can be used as a general guideline for children.

Why is Fiber Important?

Fiber helps make us full and keeps things moving in the digestive tract. A diet that includes good sources of fiber may help prevent constipation. These foods also are good sources of nutrients and vitamins that may help reduce the risk of heart disease, certain types of cancer, and obesity.

Good sources of fiber include:

• Vegetables
• Fruit
• Beans
• Peas
• Nuts
• Fiber-rich whole-grain breads and cereals

How Do You Read Nutrition Facts?

Nutrition Facts can tell you all about the nutrients and ingredients in a food. Nutrition Facts can help you choose foods that provide the nutrition that’s right for you, including fiber. Dietary fiber is a nutrient listed under “Total Carbohydrate” on the Nutrition Facts.

• Excellent sources of fiber have 5 or more grams of fiber per serving.
• Good sources of fiber have at least 3 grams of fiber per serving.

Look at the list of ingredients if you want to know if a food is made with whole grains.

• Not all foods labeled “whole grain” are a good source of fiber. Grains vary widely in their fiber content. For example, whole-grain wheat has more fiber than whole-grain brown rice or whole-grain oats.
• The amount of fiber in a whole-grain food can vary by brand.
• Whole grains include whole wheat, brown rice, bulgur, buckwheat, oatmeal, whole-grain cornmeal, whole oats, whole rye, and wild rice.