nutritional guidance for early years: food choices for children aged 1-5 years in early education and childcare settings

nutritional guidance for early years: food choices for children aged 1-5 years in early education and childcare settings

annex 2 - menu planning

Protein

The standard set is for the combination of one meal and one snack to provide 40% of the daily RNI for protein. Menu analysis shows that generally the protein content will come out higher than 40%. It is recognised that this is in line with eating patterns in the UK population and helps to provide sufficient iron and zinc in the diet.

Vitamin D

The UK Reference Nutrient Intake for Vitamin D for children aged 6 months to 3 years is 7µg/day. ¹ For children 4 years and older there is no RNI set; the action of sunlight on the skin will ensure adequate Vitamin D status. This depends on regular exposure to summer sunlight to accumulate Vitamin D stores for over the winter months. Vitamin D status in pre-school children shows variation dependent on season of the year and dietary intake of Vitamin D can be an important contributor to maintaining Vitamin D status during the autumn, winter and spring months. ^2,3 Children at risk of Vitamin D deficiency specifically are those living in northern latitudes (Scotland) and those from traditional Asian or Islamic communities (this is particularly important in Scotland in the winter months ²).

Achieving the dietary RNI is not possible in the winter months without supplementation.

Routine Vitamin D supplementation is recommended for all children over 1 year of age and should be continued until 5 years unless the diet is diverse and plentiful. ^3,4

It is essential that there is outdoor space where children can play, or have access to an outside area such as a garden, park or other safe open space. Exposure to direct sunlight on the skin (face and arms unprotected with sunscreen) in outdoor play helps children to maintain their Vitamin D status.3 The exposure time required for adequate synthesis of Vitamin D in the skin is short (10-15 minutes on face and arms in summer months) and should not conflict with 'sun policy' on protective clothing, sunhats and sunscreen.

1 Department of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects 41. 1991 London: HMSO.
2 Davies PSW, Bates CJ, Cole TJ, Prentice A, Clarke PC. Vitamin D: seasonal and regional differences in pre-school children in Great Britain. Eur J Clin Nutr 1999;53:195-198.
3 Department of Health. Nutrition and Bone Health. Report on Health and Social Subjects 49. 1998 London: HMSO.
4 Department of Health. Weaning and the Weaning Diet. Report on Health and Social Subjects 45. 1994 London: HMSO.

Iron

We have adopted a standard of 40% of RNI for iron. Children between the ages of 1-5 years have high iron requirements due to rapid growth and the build up of iron stores. A high proportion of pre-school age children in the UK have sub optimal iron intakes and iron deficiency anaemia is common in this age group. ^1,2 Iron deficiency can have lasting effects on health and development. ³ Therefore it is important that efforts are made to improve iron status of young children through improving diet.

In practice, achieving adequate iron intake is not easy and requires careful menu planning to ensure the inclusion of iron rich foods on a regular basis. ⁴ Red meats are the richest and most easily absorbed source of iron, however, breakfast cereals fortified with iron have also been shown to be an important source of iron for children. The formal childcare setting offers an opportunity through the practise of good nutrition to boost overall iron intakes.

1 Gregory JR, Collins DL, Davies PSW, Hughes JM, Clarke PC. National Diet and Nutrition Survey Children Aged 1.5-4.5 Years. Report of the Diet and Nutrition Survey, Volume 1. 1995 London: HMSO.
2 Watt RG, Dykes J, Sheiham A. Socio-economic determinants of selected dietary indicators in British pre-school children. Public Health Nutrition 2001;4(6):1229-33.
3 Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. Journal of Nutrition 2001;131(2S-2):649S-666S.
4 Gibson SA. Iron intake and iron status of pre-school children: associations with breakfast cereals, vitamin C and meat. Public Health Nutrition 1999;2(4):521-528.

Sodium

The standard set is for the combination of one meal and one snack to provide a maximum of 40% of the daily SACN ¹ recommendation for sodium for the age group 1-5 years. The sample menus given in this document do not meet the nutrient guidance for sodium. This reflects the fact that the majority of the sodium in the diet is found in processed food and also in breads. In order to address this there needs to be a marked decrease in the sodium content of food products currently used in the UK. Work is currently underway with partners in food industry to address this issue. The implementation of the product specifications for the sodium content of manufactured foods developed for school meals will help to reduce the sodium content of processed foods used in public sector catering. ²

1 Scientific Advisory Committee on Nutrition. Salt and Health Report, 2003 www.sacn.gov.uk
2 Nutrient Specification for Manufactured Products 2004 www.scotland.gov.uk/library5/education/niss-00.asp