Nutritional Guidance for Early Years: food choices for children aged 1-5 years in early education and childcare settings

Nutritional guidance for early education and childcare settings for children aged 1-5


2 Eating habits, nutrients, foods and menu planning

A varied and nutritious diet and regular physical activity are very important to ensure healthy growth and development in young children. 10,11,12 In the short term, they not only improve growth but also improve concentration and support children's learning. 10,13 There are longer term health benefits as well, as poor eating habits in childhood can lead to the development of obesity 14 and anaemia as a result of iron deficiency. 13,15
Even more importantly, a good diet in childhood can help to prevent the risk of serious diseases common in later in life, 15,16 such as cancer, cardiovascular disease, diabetes and osteoporosis.

2.1 Developing good eating habits

National Care Standard 3.31 requires that children and young people have the opportunity to learn about healthy lifestyles, including a healthy diet. This covers a number of points:

  • Encourage children to experiment: offering a variety of foods and repeatedly introducing new foods from an early age encourages children to experiment and accept different tastes and textures. 17
  • Plan snack and meal times: we already know that young children need to have structure to their day and this applies to planning times for eating and drinking. Children differ in their responses to food being made available: most children enjoy food and usually welcome an opportunity to take a snack or drink when they are hungry or thirsty. However some children are less interested, may be distracted while playing and can 'forget' or be 'too busy' to choose to eat or drink. This can result in children becoming 'over' hungry or thirsty, leading to difficult behaviour. Therefore, it is important to organise snack time so that every child has a chance to eat and drink. Snack time provides an excellent opportunity for children to: practise personal hygiene by washing their hands before eating/drinking; learn about healthy snacks and drinks; and learn to try new foods and chat to staff about their likes and dislikes. Children are more likely to try new foods if they see other children eating them. For all these reasons, a timetabled snack time, supervised by staff to ensure that every child's needs are met, is regarded as current best practice.
  • Allow plenty of time: give children enough time to finish eating and drinking - once they have started to eat, this may take around 15 minutes for a snack and 30 minutes for a meal. Children need to eat regularly and it is recommended that they be offered something to eat at least every 3 hours. Snacks are best given well before or after meal times to avoid spoiling the appetite for the next meal.
  • Develop social skills: when children sit down together to eat and drink this provides an excellent opportunity for them to learn good social skills and behaviours associated with eating and drinking. For example: chatting to other children and adults, developing good table manners, offering and sharing food, learning to respect others, tasting and trying foods from different cultures. Try to avoid distractions such as television and lots of noise.
  • Provide good role models: children often model their behaviour on others. Therefore, encouraging good food choices and eating habits in the adults, brothers and sisters, and friends around children is important in reinforcing the right messages.

Further information and activities for building positive eating habits is provided in Adventures in Foodland.4

CASE STUDY

Snacking Together at Ladywell Nursery School

Ladywell Nursery School used to run an 'open snack' system, however staff were concerned that some children were not keen to have a snack while others were limited in the foods they would try. Issues around hygiene, e.g. children washing their hands properly and the use of utensils to serve food, were also raised. It was decided that, for a trial period, snack time would be a group activity with an early years worker sitting with each group of children. Snack items were set on a tray which was taken to the group table where the children helped to prepare and serve the snack. This new way of approaching snack time was so successful that it has now been adopted as permanent practice and staff have highlighted a range of benefits:

  • Development of social skills through interaction and co-operation with others, e.g. taking turns.
  • Development of language skills as children and adults talk together about what they are eating, foods they like to eat and health issues including toothbrushing and handwashing.
  • Children are more easily encouraged to try new foods and can see what the whole food looks like before helping an adult to prepare and serve it.
  • Staff are more aware of what children are eating and can share this information with parents.
  • Children can make suggestions for foods to be included in the snack menu.
  • Staff can observe children closely, gathering information for their profiles in several areas of development.

Overall, snack time is now less stressful for the children and both children and adults enjoy it!

2.2 Foods and nutrients

Energy needs: getting the balance right

Children need energy to enable them to grow and develop and be active. Essentially, energy from food and drink provides 'fuel' for the body. Energy comes from foods containing carbohydrate, fat and protein. The precise amount of energy required for an individual child depends on their age, size, gender, rate of growth and level of activity.

For good health and optimal growth, it is important to get the balance right between energy consumed in food and energy expenditure. 14 Children who are regularly active (see section 3.4) are able to achieve a better energy balance than children who are less physically active. 14

Dietary fibre

Dietary fibre as part of a varied, balanced diet is essential for good health at all ages. Although there are no specific dietary recommendations for children aged 1 to 5 years, children who follow the 'five-a-day' guidance on fruit and vegetable intake and who have some wholegrain foods, e.g. wholegrain bread, cereals and pulses (e.g. peas, beans, lentils), incorporated into their daily diets will have an adequate intake of dietary fibre to maintain good health as they grow.

Vitamins, minerals and bioactive components

These are essential for growth, development and normal body functions. Some vitamins and minerals are important for the immune system to protect against ill health and disease. Children aged 1 to 5 have a high requirement for vitamins and minerals because of the rapid rate of growth and bone development during these years. An adequate intake of vitamins and minerals will be provided by a varied well-balanced diet, as described in the guidance. Vitamin D is the one exception to this: obtaining adequate vitamin D depends on getting enough sunlight and/or taking supplements ( see Appendix 2).

There are some compounds in foods (bioactive components) that do not fall into the categories of vitamins and minerals or nutrients, e.g. lycopene and flavonoids. Some of these compounds help to protect against ill health and disease. Vegetables, some fruits and other plant foods such as fresh herbs are particularly good sources of these.

Further guidance on the role of nutrients and key sources of nutrients are provided in Adventures in Foodland. 4

2.3 Menu planning and nutrient guidance

Menu planning

Menu planning is very important in achieving a well-balanced and healthy diet for the children in your care. It will also help you to work towards providing the quality of service described in National Care Standard 3.4. 1

Menu planning should be done by a member of staff with the knowledge and skills and an understanding of children's differing nutritional needs. The menu planning guidance set out below should be used to help produce a written menu covering all food provided, i.e. meals, snacks and drinks.

Young children have changing likes and dislikes and their appetite and willingness to try new foods varies. Different foods and portion sizes may need to be interchanged as breakfast, snacks, light meals or main meals. This need for flexibility to allow for changing eating habits has been taken into account in the guidance on food groups and menu planning. Children's cultural background should also be acknowledged and any special dietary requirements included in planning meals and snacks, as reflected in National Care Standards - Early Education and Childcare up to the Age of 16; Health and Wellbeing Standard 3.4. 1

In planning a menu it is important to include a variety of sensory qualities, e.g. taste, texture, flavours, colours and temperature. This will help children's learning and enjoyment of food. Early and repeated exposure to a food also helps children to accept it and learn to like it in the long term. 17

In the food groups and sample menus that follow, descriptions of foods and the frequency of serving are given only as a guide towards meeting the nutritional guidance. A flexible approach, building on catering experience, skills and local tastes, will allow a wide range of food and menu options to be used. The menu planning guidance is based on the five food groups (see Adventures in Foodland4 for further information).

It is important to ensure that all food is stored and prepared safely. For the most up-to-date information on food safety and hygiene for the early years see the Food Standards Agency's Eatwell website ( www.eatwell.gov.uk ). 18 It is packed with reliable and practical advice about healthy eating, understanding food labels and how what we eat can affect our health.

The Food Standards Agency has also developed specifications for the quality of processed foods to be used in school meals, 19 which may be useful for foods used in catering for the early years sector.

Menu Planning by Food Group

Group 1: Bread, Other Cereals and Potatoes

Guidance for Children aged 1-5 years

Why?

All types of breads, other cereals (breakfast cereal, oats/oatcakes, rice, pasta, noodles, couscous, maize meal), potato and starchy root crops (e.g. sweet potato, yam), green plantains

Every meal and most snacks should contain a portion or portions of food from this group.
Early introduction to wholegrain cereal foods helps children to accept these as a regular part of their diet.
Fibre-enriched cereals (i.e. breakfast cereals with added bran) should not be offered to children under 2 years.

Starchy foods provide essential energy for children and are an important source of many vitamins, minerals and fibre. Encourage children to eat these foods to satisfy their appetites.
Wholegrain/wholemeal bread, wholegrain cereals (e.g. wheat biscuits, mini wheats, porridge), pasta and brown rice, as well as the white varieties, should be offered to encourage children to enjoy these as part of a varied diet.
Young children have small stomachs and too many foods with added fibre such as fibre-enriched (bran-type) breakfast cereals (e.g.
All-Bran, Branflakes, raw bran) can replace energy-rich foods needed for growth and interfere with the absorption of essential minerals such as calcium and iron.

Bread

A variety of breads: wholegrain/wholemeal, brown, white, bread-based snacks (e.g. yeast-type buns, scones) should be available daily as part of a meal and/or snack for all children. Crusty bread, quarters of bread rolls and buns are popular and can be offered at snack or meal times.
As part of a meal, bread (including naan, pitta and crusty bread) can be provided in a variety of forms.

Bread provides for the varying appetites and energy requirements of young children.
These provide variety and make the diet more interesting.

Breakfast cereals

Breakfast cereals may be offered at breakfast or snack time. A variety of low-sugar breakfast cereals, e.g. wheat biscuits, porridge, cornflakes, rice snaps, unsweetened puffed wheat, should be available. These breakfast cereals are low in added sugars a (most of these products contain less than 15% added sugars, a i.e. less than 15g per 100g). There are plenty of breakfast cereals with a low added sugar a content to choose from.
Highly sugared cereals and cereal bars should not be offered (e.g. chocolate-coated cereals, frosted flakes, honey-coated cereals, cereals with sweet sticky bits). Many of these have a high added sugar a content of more than 15% (more than 15g per 100g of product). Low-salt varieties are also sometimes available.

Breakfast cereals are a popular food with young children; they provide energy, many vitamins, minerals and fibre. Many varieties are fortified with iron, folate and other nutrients, providing an important source of these in the diet. In addition, as they are usually eaten with milk, this provides further nutrients, such as calcium, phosphorus, protein, etc.
Breakfast cereals with a high proportion of added sugars a provide a poor balance of energy for young children. Too much added sugar a leads to dental decay and obesity. Choose cereals that are lower in added sugars a and, where available, low in salt.

Potatoes, sweet potatoes, yams

Fresh cooked potatoes should be served regularly in different ways: mashed, boiled, oven baked or as potato wedges or roast potatoes with a light coating of olive, sunflower or rapeseed oil.
The following high-fat processed potato products should be served a maximum of once in a full 5-day menu: chips, smiley faces and other shaped products, processed croquettes and waffles.
All processed potato products should be oven baked rather than fried.

Fresh cooked potatoes served in different ways provide a variety of textures. They are an excellent, high-quality source of energy and nutrients for children. They are rich in the B vitamins and an important source of vitamin C.
Many of the high-fat potato products contain poor quality fat (hydrogenated fats) and are also high in salt. If eaten frequently, they can lead to an imbalance in energy and fat intake.

Rice, pasta, noodles, couscous

These foods are popular with young children and should be provided regularly as alternatives to bread and/or potatoes. Wholegrain varieties are suitable for all children. They may be enjoyed as part of hot or cold dishes, in soups and combined with vegetables. There is no need to add salt when cooking foods from this group.
Processed pasta and rice products (e.g. noodles in a pot, savoury rice in a bag and tinned spaghetti hoops in sauce) tend to have a very high salt content.
Manufacturers are working to produce lower salt versions, so if canned spaghetti and similar products (e.g. spaghetti hoops, pasta shapes) are used, choose the reduced salt varieties.

These foods are a good source of carbohydrate energy and B vitamins. They provide a variety of textures and tastes for young children. Wholegrain varieties of rice and pasta are higher in B vitamins than the white varieties.
These processed products are mostly very high in salt and if eaten regularly they will contribute to a high-salt diet.

Group 2: Fruits and Vegetables

Guidance for Children aged 1-5 years

Why?

Fresh, frozen, canned and dried varieties of fruits and vegetables and fruit juices

Every meal should contain a minimum of between one and two child-sized portions from this group ( see Appendix 4).
The snack and meal combinations should provide a variety of vegetables and fruits. Children may prefer raw vegetables (e.g. cucumber, tomato, carrots, celery).
They may find them easier to eat if served cut up into small portions (e.g. chopped apple and satsuma segments). Offering them repeatedly may improve acceptance.
Offering fruit and raw vegetables (e.g. chopped apple, chopped cucumber) at the beginning of the meal, or as a snack, may help to improve uptake.
Tinned fruit should be in fruit juice or natural juice and not in syrup.
Choose tinned vegetables in water with no added salt.

Fruit, vegetables and salads are rich sources of vitamins, minerals and other bioactive components, which protect children from ill health. This protection begins early and continues throughout life.
They also provide an excellent combination of fluid and fibre to help prevent constipation in young children.
Offering these colourful foods with a variety of tastes and textures stimulates children's interest in fruits and vegetables as well as challenging their palates.
The introduction of a variety of fruit and vegetables at a young age may improve consumption throughout life. This will help to meet the recommendation of five portions a day.
Offering raw chopped fruits and vegetables at the beginning of a meal when children are most hungry and 'waiting' for their food is an excellent way to get them to eat more foods from this group.
Tinned fruit in syrup has a high added sugar a content, which contributes to tooth decay.
Many tinned vegetables are in brine, which is salted water.

Vegetables (green and salad vegetables, root vegetables, pulses)

Serve vegetables so that they are appealing and user-friendly. They may be popular cold, raw, as finger foods, served with fruit in salad or incorporated into main dishes.
Fresh soups with vegetables are an excellent way of including pulses and vegetables in a meal. There should be a minimum of one portion of vegetables in each serving of soup.
Most dried and tinned soups are very high in salt and some have a low vegetable content. Avoid these foods as they make it difficult to meet the nutrient guidance for sodium (salt).
Baked beans are nutritious and popular with children; when serving them, choose lower salt versions.
Canned spaghetti and similar products, e.g. spaghetti hoops, pasta shapes and tomato ketchup, are not vegetables and therefore do not count as a portion.

Vegetables are essential for a balanced diet. They contain unique protective components that are not found elsewhere in the diet. Be creative to encourage young children to consume them on a daily basis. Some children prefer vegetables raw as finger food or incorporated into dishes raw rather than served in the traditional way.
It is not uncommon for canned spaghetti or pasta shapes in sauce to be mistaken for a serving of vegetables.

Fruit

Fruit should be offered with every meal and most snacks. Fruit-based desserts, such as fresh fruit, tinned fruit in juice, fruit salads, fruit crumble, fruit jelly or fruit pie, are popular options for young children. These composite fruit dishes should contain a minimum of one portion of fruit per serving.
Most fruit yoghurts provide less than one portion of fruit and therefore fresh fruit should be offered in addition to fruit yoghurt.
Pure fruit juice is a good source of vitamin C.
A small glass or cup of pure unsweetened fruit juice, taken as part of a meal, provides enough vitamin C for the day. Fruit juice should be given only at meal times.
Dried fruit is an excellent source of nutrients but because of its high sugar content should be given at meal times only.

There are many fruit-flavoured sweet products on the market, many of which contain little or no fruit but are simply flavoured to resemble fruit. Make sure that fruit desserts have a high proportion of real fruit so that they contribute to overall daily fruit intake.
Fruit juice is high in added sugars a and acidic, and drinking juice alone (i.e. not as part of a meal) contributes to tooth decay. Fruit juice and other drinks should always be served in a cup or glass (with or without a straw) rather than from a bottle.
Dried fruit has a high nutritional value and is a good food for children to learn to enjoy. However, as it sticks to teeth and can cause dental decay, it should be provided at meal times only.

Group 3: Milk and Dairy Foods

Guidance for Children aged 1-5 years

Why?

Milk and dairy foods, yoghurts and milk-based desserts

All meal and snack combinations should contain a portion or portions of food from this group.

In children aged 1-3 there is rapid development of the teeth and bones as they grow and move around more independently. Calcium, vitamin D, phosphorus, protein and other minerals are essential for this stage of development and are particularly well absorbed from milk and milk products.
Milk and milk products provide a rich source of some of these nutrients. Diets that do not include any milk and dairy foods are unlikely to meet the calcium requirements for young children. If a child does not have these foods (e.g. is vegan), parents/guardians should seek advice from a health professional to make sure that there is adequate calcium in the diet.

Milk

Plain drinking milk should be available as an option every day. Some children may still be having breast milk at and beyond the age of 1 year. For 1 year olds, who are not being breastfed, whole cows milk should be the main milk drink until the child is at least 2 years old. From age 2, semi-skimmed milk can be introduced as long as the child is eating well and getting enough energy and nutrients from a varied diet. Fully skimmed milk is not suitable as a main milk drink for children under 5 years. From 5 years old fully skimmed milk can be used.
Where only one type of milk is available (e.g. in the nursery setting), whole milk should be provided.
Drinking milk should be an accompaniment to meals and snacks and not a replacement for them.
Plain milk should be provided. Flavoured milks are unsuitable because of their high sugar content.

Milk provides essential nutrients and fluid in a readily available form. Whole milk is also an important source of energy for young children.
Low-fat skimmed milk contains insufficient energy and fat-soluble vitamins for children aged 1-5 years.
Occasionally a child will get into the habit of drinking large amounts of milk (more than 500ml per day) instead of eating other foods. This may happen after a period of illness simply because the child refuses to eat solid food. Young children who persistently drink large amounts of milk rather than eating will have a diet that is deficient in energy and other nutrients, e.g. iron and B vitamins.
Flavoured milks are high in added sugars and can cause tooth decay. They are also very sweet and encourage a 'sweet tooth'.

Yoghurt

Yoghurt is very popular with children and there is a huge variety of fruit-based and fruit-flavoured yoghurts to choose from.
Whole-milk/plain natural yoghurt/plain fromage frais does not have added sugar a. These are ideal options and can be served with fresh, stewed or frozen fruit, or fruit in natural juices.
At meal times, choose whole-milk fruit yoghurt/fruit fromage frais that is low in added sugar a.
Novelty yoghurts, e.g. cartoon-type, corner-type yoghurts with bits, mousses and yoghurts in a tube are mostly very high in added sugars a. Some contain crumbly and sticky substances (e.g. chocolate, fudge), which stick to the teeth and cause tooth decay. These should not be provided.
Other dessert type foods for children in cartons like yoghurt may be more like sweets or chocolate and contain little milk or fruit. These should not be provided.

Yoghurts can be an excellent source of calcium, protein, vitamin A and small amounts of vitamin D (whole-milk variety) and they are easy to eat.
There is a huge choice of yoghurts on the market and it is often difficult to know which gives the best nutritional value. Some are less healthy than others: avoid those with sticky sugared bits like sweets.
Plain yoghurt and plain fromage frais is the best option and can be taken as part of a snack or meal.
Fruit-flavoured yoghurts containing low amounts of added sugars a are less harmful to teeth 20 than yoghurts high in sugars and those with sticky sweet bits.
The sweetened sticky additions to many novelty yoghurts are harmful to children's teeth and can contribute to excess energy intake from sugar.
Yoghurt should be eaten using a spoon and sweetened yoghurt should not be sucked from a tube as this is harmful to children's teeth.

Cheese

Cheese can be served as the main protein item instead of meat, fish or pulses.
Cheese can be served as cheese and biscuits, cheese and fruit, as part of a salad or as a filling for sandwiches and baked potatoes, or sprinkled on top of pasta or rice dishes. A suitable small portion of hard cheese for a young child is around 20-25g.
Cottage cheese makes a nice change from hard cheese and can be served in a larger portion of 40-50g.
Cheeses suitable for vegetarian children should be available.

Cheese is a concentrated source of calcium and other minerals. The protein and mineral content may also help to promote dental health.
Where a portion of cheese is served as the main protein item, it also counts as a portion of food from the meat, fish and alternative sources of protein food group.
Most hard cheeses and full-fat soft cheeses, though good foods, are high in saturated fat, so stick to the portions recommended to avoid excess intake.
Vegetarian children will not take cheese that contains rennet as it is an animal-based ingredient.

Group 4: Meat, Fish, Eggs, Pulses, Seeds and Nuts

Guidance for Children aged 1-5 years

Why?

Meat, fish and alternatives, e.g. eggs, peas, beans, lentils and nuts

Every main meal should contain a portion or portions of food from this group.

Meat, fish and alternatives such as eggs, beans and pulses are a major source of protein, iron and zinc. These help to promote growth in children. Most children living in the UK have more than adequate amounts of protein in their diet.

Beef, pork, lamb and poultry

Red meat (beef, pork and lamb) -based meals should be served a minimum of twice a week.
Lean meat (fat trimmed off) should be used in composite dishes.

Red meat is the best source of iron and a major source of zinc. Lean meats are higher in protein, iron and zinc than meats with a high fat content.
This will help to improve the nutritional quality of meat used in recipes such as spaghetti bolognese, casseroles and stews.

Processed meat products and pies

Processed meat products, i.e. hot dogs, frankfurters, sausages, processed beef burgers, and meatballs, haggis and shaped poultry products (e.g. nuggets), pastry-topped pies and other pastry products (e.g. bridies, sausage rolls, Cornish pasties, Scotch pies) should be served a maximum of once a week.
The vegetable content of composite dishes such as homemade pies should be increased where possible. Potato-topped pies should be encouraged in preference to pastry-topped pies because of their lower fat content. Do not add salt.

Processed meat products are mostly high in fats and salt. The quality of fat may be unhealthy (high in saturated and hydrogenated fats) and the quality of protein poorer than in fresh or frozen leaner meats. Also they may be lower in iron and zinc than lean meats.
Using potato in a pie provides energy and varies the texture of a composite dish while also adding more nutrients, e.g. vitamins and minerals.

Composite dishes

These dishes, e.g. lasagne, moussaka, spaghetti bolognese, tuna pasta bake, ravioli, etc., should contain lean meats, small amounts of cheese and plenty of vegetables. Always increase the vegetable content whenever possible and do not add salt.
When fat is used in cooking or in dishes, use a vegetable oil high in monounsaturated or polyunsaturated fat, e.g. olive oil, rapeseed oil, sunflower oil or safflower oil.

Vegetables can be easily incorporated into these dishes or cold salad items (cucumber, tomato, lettuce, celery and carrot) can be served alongside as finger foods. This will help to increase the vegetable intake.
Vegetable oils high in monounsaturated and polyunsaturated fats improve the type of fat in the diet.

Fish

Fresh or frozen unprocessed fish, in addition to tinned tuna, should be on the menu at least once in a full 5-day menu.
Oil-rich fish: sardines, kippers, salmon, mackerel, fresh tuna and herring (excluding tinned tuna) should be served at least once in a full 5-day menu.
Processed fish products, e.g. fish fingers and shaped fish products, may be high in salt and should be served no more than once in a full 5 day menu.

This will provide variety. Tinned tuna fish is lower in protective fatty acids than other types of oily fish. This does not apply to fresh tuna. 21,22
Oil-rich fish contain valuable, protective fatty acids that are deficient in the Scottish diet so we need to increase their intake. Oil-rich fish are also one of the few naturally rich sources of vitamin D. Many children are not familiar with these foods and should be encouraged to try them by introducing tasters (e.g. sardines on toast).
Many of these products are high in salt, although manufacturers are starting to produce varieties with a lower salt content.

Chopped nuts, nut pastes and nut/seed pastes

Nuts should not be given whole to children aged 1 to 5 years as there is a risk of choking.
Chopped nuts and nut pastes can be offered.

Chopped nuts may be used in recipes.
These are a good source of energy, protein and minerals.
You will need to be careful with children who may have a nut allergy (see section 3.7).

Vegetarian sources of protein
(see section 3.5 for more details about vegetarians)

Protein sources for vegetarians include: pulses, seeds, chopped nuts, seed/nut pastes, eggs, cheese, yoghurt, tofu and soya mince. These should be varied through the week.
Soya mince, textured vegetable protein ( TVP), quorn and tofu can be substituted for mince and chicken in main composite dishes, e.g. spaghetti bolognese, casseroles, stir-fries.
Processed vegetarian products resembling meat products, e.g. sausages and veggie burgers should be served no more than once a week.

These should be the main sources of protein for vegetarians. The protein content of vegetarian dishes is often lower than in meat dishes. However, vegetarians can get sufficient protein from these dishes along with the other sources of protein in their diets, e.g. cereal protein, milk products. Pulses, including beans, lentils and peas provide excellent nutrition, including protein. They are very versatile foods for quick light meals and as ingredients in soups and casseroles. Pulses can be an alternative to a portion of meat, fish, eggs or cheese. This increases the variety for vegetarians.
Many meat substitutes are similar in texture to meat and may not appeal to children who do not like meat. Also, some may be high in salt.
Processed vegetarian products are mostly high in fats and salt. The quality of fat in some of them is unhealthy (hydrogenated fats).

Group 5: Foods High in Fat and Foods and Drinks High in Added Sugars a

Guidance for Children aged 1-5 years

Why?

This group includes butter and spreads, cooking fats and oils, desserts, confectionery, cold and hot drinks, savoury snacks and bottled sauces

Within this group there are certain foods that make an important contribution to the diet of children, e.g. butter, spreads, cooking oils, fruit and milk desserts.
Also within this group are foods that are high in added sugars a or poor quality fats and/or salt, e.g. soft drinks, sweets, chocolate confectionery, chocolate and cream-filled biscuits, sugary pastries, sugary desserts, highly sweetened cereals, sugary sticky yoghurts, corn snacks and crisps. These snack-type foods are often unhealthy and unnecessary.
Bottled sauces are generally very high in salt and should not be encouraged as part of the meal.

Butter, spreads and oils contribute to the taste, texture and enjoyment of the diet. They are important as concentrated sources of energy for young children who are growing rapidly. Fruit and milk desserts offer good sources of vitamins and minerals and are a pleasant change from savoury foods.
These foods are eaten too often by many children, especially if they have frequent and easy access to them. This contributes to a poor-quality diet, which can result in obesity, poor growth, tooth decay and general poor health. The over consumption of snack foods high in added sugar a, fats and salt is recognised as one of the major problems we have in Scotland.

Desserts: puddings, cakes, biscuits, jam, jelly and ice cream

All desserts offered should be fruit- and/or milk-based (including yoghurt and ice cream).
Encourage caterers to review home-baking recipes to reduce fats and added sugars a and include nutrient-rich, wholefood ingredients, e.g. dried fruit/fresh fruits. Home-baking/bakery products can be offered in mini-portions (e.g. 25-35g) as an accompaniment to fruit as a dessert.

Desserts and puddings are popular and are important for boosting the total energy in children's diets but they should also provide nutrients. They can also help to increase fruit and milk intake.
There are a wide range of these products marketed at children and we need to be careful to select those with a high milk and/or fruit content and low added sugars a.
The portion size of home baking/bakery products is too big for young children, e.g. large muffins. Mini-portion sizes are much better and served along with fruit will improve the balance of the diet. Children enjoy the different tastes and texture this provides.
Butter and spreads
Only butter or spreads rich in monounsaturated and polyunsaturated fats and oils should be used, e.g. olive, rapeseed, sunflower or safflower oil. These can be spread on breads and used in baking.
Cooking margarines and low fat spreads of less than 40% fat are not recommended.
These provide an important source of energy, essential fats and fat-soluble vitamins for children. They help to achieve a healthy fat profile in the diet.
Cooking margarines are high in hydrogenated fats. Young children rely on fat as a major energy source, low fat spreads are low in energy.

Cooking fats and oils

Only those rich in monounsaturated and polyunsaturated oils should be used e.g. olive, rapeseed or sunflower oil.

They provide an important source of energy and essential fats for children. They help to achieve a healthy fat profile in the diet.
Sweetened soft (still and fizzy) drinks, sweets, confectionery, chocolate, ice-poles, sugary pastries, chocolate biscuits
Sweetened soft (still and fizzy) drinks, sweets, confectionery, chocolate, ice-poles, sugary pastries, chocolate and cream-filled biscuits should not be provided as part of the menu.
Sugary and/or fizzy drinks should not feature as part of pre-school children's diet as they are associated with tooth decay and can contribute to poor nutritional health and excessive weight gain (see section 3.3).
Milk and plain water are suitable drinks for throughout the day and for between meals.
Fresh unsweetened fruit juice should be offered only at meal times. Juice should be drunk from a cup or glass and not from a bottle.
These foods are energy-dense because of their high added sugar a and/or high fat content. Many of them are of poor nutritional quality, providing little vitamins or minerals.
A regular high intake of these foods by young children will replace foods of higher nutritional quality and result in an imbalance in the total diet. This can result in obesity, iron deficiency and poor growth. As these foods are currently consumed in large amounts by Scottish children, we need to pay particular attention to guiding children and families to reduce over consumption.
Milk provides an important source of nutrition for young children. Water provides essential fluid and, along with fibre, helps to prevent constipation.
Fresh fruit juice should be distinguished from 'fruit drinks'. Fruit drinks often contain very little or no fruit juice at all and are often high in added sugars a and acids. Fruit juices are not suitable for drinking between meals because of their high sugar and acid content.

Group 5: Foods High in Fat and Foods and Drinks High in Added Sugars a

Guidance for Children aged 1-5 years

Why?

Savoury potato snacks, crisps and corn snacks

Crisps can be offered as part of a snack or meal option as an alternative texture and taste, e.g. beside a filled sandwich or salad dish. However, they should not be provided as the main staple of the meal and should not be included more than twice on a full 5-day menu. For young children, this would be a small portion (e.g. 10-15g).

These are popular with children and can provide a change of texture and taste. They should not be regarded as replacing one of the main staple foods (i.e. breads, potatoes, rice, pasta or cereals). They are high in salt and so the portion size and frequency with which these foods are offered should be limited.

Table salt, bottled sauces, relishes and pickles

Do not add salt to food during cooking or at the table.
Bottled sauces (e.g. ketchup) are popular with children and may be high in salt and sugar. They can be given occasionally in very small portions only at meal times (e.g. 5g).

These foods contribute to excess sodium (salt) intake in young children. Eating them on a regular basis in large amounts can contribute to a high-salt diet.

a Added sugars: these are sometimes known as non-milk extrinsic sugars ( NMES) or free sugars and are found in sweets, biscuits, soft drinks, breakfast cereals, table sugar, honey, and fruit juice. They are not found in plain milk or in foods such as fruit and vegetables.

Nutrient guidance

The information in Appendix 1 provides guidance on providing adequate energy and nutrition for children aged 1 to 3 years and 3 to 5 years attending partial day care or pre-school education. The nutrient guidance is based on UK Dietary Reference Values, 23 which is an average reference value for groups of children and does not apply to individual children. As individuals, children have different energy and nutrient requirements depending on their age, gender, body size, rate of growth and level of activity.

For young children, there are no hard and fast rules about what must be served as a breakfast, a snack, a light meal or a main meal. Depending on likes and dislikes, their appetite and their willingness to try foods, food items can be interchanged for snacks, meals or breakfast. For this reason, nutrient guidance has been given for one meal, including drinks ( Appendix 1, Table 1) and also for the combination of one meal and one snack ( Appendix 1, Table 2). Some children receive only a snack and drink while in nursery, so suitable snacks and drinks for children aged 1 to 5 are listed in sections 3.2 and 3.3.

The nutrient figures in Table 1, Appendix 1, represent the recommended nutrient intake provided by one meal averaged over 5 days. A period of 5 days is used because nutrient requirements are generally met over a period of time, rather than within one day. This would apply, for example, to the meals (e.g. lunch) provided to children aged 1 to 5 years who are in early years care.

Table 2, Appendix 1, represents the recommended nutrient intake provided by one meal and one snack averaged over 5 days. This would apply, for example, to a combined meal and snack (e.g. morning snack and lunch) provided for children who are in early years care.

There are some key issues about nutrient provision to consider when menu planning. These are detailed in Appendix 2.

2.4 Example menus

The following menu has been designed to meet the nutrient guidance for 1 to 5 year olds averaged over a normal 5-day care-provision period. Each day's menu identifies all meals, snacks and drinks offered throughout the day (with the exception of plain water, which is assumed to be offered to children regularly throughout the day, including at meal times).

There are difficulties with achieving the dietary reference value for sodium (salt) for all children and for vitamin D for children aged 1 to 3 ( Appendix 2). Two sets have been provided to demonstrate potential planning over a 10-day period. The following menus are examples only and are expressed in practical household measures. These are as follows: teaspoon (tsp = 5ml), dessertspoon (dsp = 10ml), tablespoon (tbs = 15ml) and a mug measures 300ml to the brim.

More accurate weights for each food item may be required and for this the example menus with weights of foods have been included in Appendix 3. The weighted menus are given for 1 to 3 years and 3 to 5 years separately to illustrate the food requirements for the different age groups.

Staff who are responsible for planning menus need to be supported by proper training and this is discussed further in section 4.4. They should also be encouraged to be creative in adapting menus to provide for children with special needs, therapeutic diets, religious requirements ( Appendix 5) or vegetarian diets. Some alternatives for vegetarian choices have been provided as examples.

Some points to note when reading the example menus to follow are:

  • Drinks
  • Only milk and plain still water are offered between meals.
  • Pure, unsweetened orange juice is provided only at meal times.
  • Where only one type of milk is available, whole milk will be used.
  • Water is provided in addition to, rather than as a replacement for, the milk included in the menus.
  • Dried fruit is provided only at meal times.
  • The spread used is monounsaturated or polyunsaturated.
  • Sauces used in composite dishes, e.g. spaghetti bolognese, macaroni cheese, and soups are made from fresh ingredients and are not processed, ready-made varieties which are high in salt.

To check the quality of your planned menus, a menu checklist is included in Appendix 6.

Menu 1: A 10-day menu for children aged 1 to 5 years with suggested portions in household measures

Day

Breakfast

Mid-morning snack

Lunch

Mid-afternoon snack

Tea

1

2 tbs pure, unsweetened orange juice diluted with water a

porridge ( 1/ 3- 1/ 2 mug) served with milk

1 small slice toasted wholemeal bread with spread d and jam

1 small glass of milk

1 mini/medium Scotch pancake with spread

1 tangerine

spaghetti bolognese b (approx 1/ 2 mug spaghetti and 1/ 2 mug sauce) with added chopped carrot

(1 baby carrot)

3-5 tbs custard and apricots (2-5 stewed dried apricots)

1 small glass of milk

finger food selection including:

1/ 2 small banana, fresh apple slices ( 1/ 2 medium apple), served with 1-2 heaped tbs of plain yoghurt as a dip

grated cheddar cheese,
(1-3 tbs) and tomato slices, (3 or 4) - sandwiched between 2 slices of toasted white bread with spread

mandarin orange segments in juice (1-2 tbs) with 1 scoop of vanilla ice cream

2

2 tbs pure, unsweetened orange juice diluted with water a

1-2 biscuits of Weetabix served with milk

1 small slice toasted wholemeal bread with spread and jam

1 small glass of milk

finger foods selection including:

2-4 bread sticks

2-3 cheese cubes (1-1 1/ 2 tbs grated)

apple chunks ( 1/ 2 medium apple)

1 mini/small wholemeal pitta bread filled with 1 or 2 thin slices of roast chicken, b 1 tbs of sweetcorn, 2 sliced cherry tomatoes, diced cucumber (1cm piece)

milk jelly (2-4 tbs) with 2 tbs chopped pineapple

1 small glass of milk

mini fruit scone with spread

1 plum

small bowl of vegetable soup - ( 1/ 2- 3/ 4 mug served with 1 medium/thick slice of crusty white bread (with spread)

3-5 tbs custard and peaches (2-3 slices)

3

2 tbs pure, unsweetened orange juice diluted with water a

1 sliced hard-boiled egg c served with a small slice of toasted wholemeal bread with spread

1 small glass of milk

1 toasted teacake with spread

1-1 1/ 2 large pork and beef sausage b (grilled) served with a small baked potato and 2 tbs baked beans

2-3 dried apricots

1/ 2-1 tbs raisins

1 small glass of milk

1/ 2 small banana sliced

1 dsp plain fromage frais

chicken risotto b ( 1/ 2-1 mug) with 1-2 large sliced mushrooms

apple crumble (2-3 heaped tbs) served with milk

4

2 tbs pure, unsweetened orange juice diluted with water a

3-5 tbs cornflakes with milk and 1 dsp raisins

1 small slice of toasted white bread with spread

1 small glass of milk

1 small banana or finger food selection, e.g. 1/ 2 banana and 4 grapes

1 sliced hard-boiled egg c with wholemeal bread soldiers (1-1 1/ 2 slice bread), with spread

rice pudding ( 1/ 3- 1/ 2 mug) with 1/ 2-1 dsp sultanas

1 small glass of milk

1 mini (or 1/ 2 large) muffin toasted with spread

1 small slice of melon

minced beef in gravy b
( 1/ 3- 1/ 2mug) served with
2-3 tbs mashed potatoes and a spear of broccoli

fruit cocktail in juice ( 1/ 3 mug)

5

2 tbs pure, unsweetened orange juice diluted with water a

1 1/ 2-2 tbs baked beans served with a toasted muffin with spread

1 small glass of milk

1/ 2-1 crumpet with spread

1/ 2-1 fresh peach

1-1 1/ 2 wholemeal rolls with spread and filled with 1-2 thin slices of ham b, 1/ 2 a sliced tomato, carrot sticks (1 baby carrot)

apple sponge pudding (2-3 tbs)

1 small glass of milk/water

1/ 2-2 slices of pineapple in juice served with 1-2 tbs of plain yoghurt

1/ 2-1 grilled salmon steak, basted with olive oil and served with 2 or 3 new potatoes and small portion green beans

1 small carton fruit fromage frais served with 3 or 4 strawberries

6

2 tbs pure, unsweetened orange juice diluted with water a

7-10 tbs puffed wheat served with milk

1 small/medium slice toasted white bread with spread and jam

1 small glass of milk

finger food selection including:

6 sliced grapes (6 grapes), 1/ 3 small banana, melon
(3 chunks)

lean beef stew b ( 1/ 2 mug) served with 2 or 3 boiled potatoes

boiled turnip and carrot (1 small)

fruit crumble (2-3 tbs) and custard (3-4 tbs)

1 glass of water

1 mini blueberry muffin

apple slices ( 1/ 2 small/medium apple)

1 medium/large slice of ciabatta filled with 3-4 tbs grated cheddar cheese and 3 slices of tomato

1/ 2-1 carton fruit yoghurt with 1/ 2 pear in juice

7

2 tbs pure, unsweetened orange juice diluted with water a

porridge ( 1/ 3- 1/ 2 mug) made with milk served with milk

1/ 2 slice toast with spread

1 small glass of milk

1 mini plain scone (or 1/ 2 scone) with spread

1 tangerine

1 mini/small pitta bread filled with tuna b and 1-2 dsp sweetcorn mixed with 1-2 tbs plain yoghurt served with 2-3 sliced cherry tomatoes

milk jelly (2-4 tbs) topped with mandarin oranges
(2 tbs)

1 small glass of milk

finger food selection including:

carrot sticks (1 small), cucumber (1cm piece chopped) and 2-3 sliced cherry tomatoes

large cracker served with
2 tbs plain yoghurt as dip

spanish omelette c (1 egg) and 1 small baked potato

apple pie (1-2 tbs) with
1 scoop of vanilla ice cream

8

2 tbs pure, unsweetened orange juice diluted with water a

1 small glass milk

1 small slice of toasted wholemeal bread with spread and topped with
1 rasher of grilled bacon and 3 or 4 slices of tomato

1 small glass of milk

1 small/medium banana

2 tbs pure, unsweetened orange juice diluted with water c

1-2 slices of crusty bread with spread and topped with 2 canned sardines b (mashed) and 3 slices of tomato chopped

1 carton of fruit yoghurt with 6 chopped grapes

1 small glass of milk

1 mini/small Scotch pancake with spread

3 or 4 strawberries

lentil soup ( 1/ 2- 3/ 4 mug)

1 small slice wholemeal bread with spread, topped with 1-2 thin slices of cold roast turkey b, lettuce,
3 slices of tomato and
1-2 tsp cranberry sauce

9

2 tbs pure, unsweetened orange juice diluted with water a

porridge ( 1/ 3- 1/ 2 cup) made and served with milk

1 small slice of toasted white bread with spread

1 small glass of milk

1 mini/medium cheese scone with spread served with 3 sliced cherry tomatoes

mild chicken korma b ( 1/ 3- 1/ 2 mug) served with 2-2 1/ 2 tbs boiled rice and a slice of naan bread ( 1/ 6- 1/ 3 large naan)

2 tbs fruit yoghurt

1 small glass of milk

1 small banana or finger food selection: chopped banana, 1/ 2 apple and 1 oatcake

1-2 mini wholemeal rolls with spread, filled with 1 sliced hard-boiled egg, c 2 slices of tomato and mustard and cress

sponge pudding (2-3 tbs) and fruit cocktail (2 tbs)

10

2 tbs pure, unsweetened orange juice diluted with water a

1 scrambled egg c served on a small/medium slice of toast with spread

1 glass of water

1-2 dsp of plain fromage frais

1 fresh plum

vegetable lasagne ( 1/ 2-1 mug) served with 1 slice of garlic bread

1/ 3- 1/ 2 mug rice pudding topped with 1 heaped tbs of pureed apples

1 small glass of milk

1 or 2 crackers with cheddar cheese (1 1/ 2 tbs grated or 1/ 2-1 matchbox size piece) and apple ( 1/ 2 medium)

minestrone soup ( 1/ 2- 3/ 4 mug)

1-2 slices of toasted white bread, with spread and topped with 1-1 1/ 2 slices ham b and a pineapple ring

a We suggest that pure, unsweetened orange juice is diluted about 50:50 juice to water throughout. However it can be served undiluted, or with a greater proportion of water to juice if a longer, more thirst-quenching drink is preferred.
b For vegetarian options for meat, fish and chicken the following can be used as substitutes: for beef stew, beef could be substituted with chickpeas or kidney beans; in bolognese, meat could be substituted with soya mince; cheese, hummus or egg could replace tuna; chicken could be substituted with lentils or chickpeas. Other suitable substitutes are veggie sausages, quorn, peanut butter, baked beans, cheese and bean burgers.
c Where fresh eggs are not used to avoid the risk of Salmonella, sliced hard-boiled eggs and scrambled eggs can be substituted with dried powdered egg.
d The spread used is monounsaturated or polyunsaturated - this applies to all references to 'spread' throughout the document.

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