Answers to Parents’ Most Common Questions on Healthy Eating for Kids

By Vanessa Chrisman, clinical dietitian at CHOC Children’s

Healthy eating for kids is an essential part of their overall healthy lives. For children, it’s especially important because their growth and development depends on it. Parents play a large role in providing a healthy diet for their children, as well as establishing lifelong habits when it comes to food. In today’s world of fad diets and conflicting headlines about nutrition and health, it can be confusing for parents to navigate how to feed their children appropriately. Here are some of the most common nutrition questions I get from the parents of my patients.

My child wants to eat the same food every single day. Is this okay? How do I handle this?

Typically, toddlers are the ones who go on food jags – wanting to eat the same food at every meal, day in and day out. It often is a show of independence. This can happen with older children too. While it’s okay to eat the same healthy food every day, it’s the parents’ job to choose what foods to offer at meals. As an example, maybe your child wants cereal at every meal. Rather than provide this, offer other healthy foods and tell your child that she can have cereal for breakfast the next day. Your child then gets to choose whether she eats what is offered at that meal. If she doesn’t, don’t worry. Simply be patient and wait until the next snack time to offer more food. When your child becomes hungry, she will most likely eat what is offered.

My child is a picky eater. How can I convince him to eat more fruits and vegetables?

Start by serving a fruit and a vegetable with every meal. Serve the foods that he already accepts and eats. Introduce one new fruit or vegetable at a time. Make new foods more appealing by cutting them into fun shapes and sizes. Vegetables can be spiralized to look like pasta. Fruits can be cut into stars or dinosaurs with cookie cutters. Set a good example by eating fruits and vegetables regularly as a family. As parents, you are powerful role models for your children who are always watching and listening. Let your child help pick out fruits and vegetables in the grocery store as well as wash them at home. Fruits can be added to smoothies and yogurt and cereal. Vegetables can be cooked into spaghetti sauce or added to stir-fried rice or soups. Sometimes children will want to try new fruits and vegetables if you serve them with a favorite dip or sauce. Consistently serve fruits and vegetables at your meals and be patient. Limit grazing between meals to build hunger and avoid preparing a special meal for your picky eater. Eventually your child will come around and try some of these new foods. Praise the behaviors you want to encourage and give less attention to the pickiness or refusal to try new foods.

I don’t think that my toddler eats enough protein. How much is enough?

Many parents worry that their toddler is not getting enough protein in their diet. The truth is that it is quite easy for a toddler to meet his protein needs. Toddlers ages 1 to 3 need 1.2 grams of protein for every kg of body weight. This means that a healthy 2-year-old boy who weighs 27 pounds (or 12 kg) needs about 14-15 grams of protein per day. His protein needs could be met simply by: drinking eight ounces of one percent milk (eight grams protein) and eating two tablespoons of ground turkey or one large egg (seven grams of protein) in a day. If he drinks sixteen ounces of milk, his daily protein intake increases to 23 grams of protein, which is 150 percent of what he needs. Unless a toddler is eating a very restrictive diet, it’s rare for him to consume a diet low in protein.

My child loves to drink juice and soda but barely drinks any water. How can I get her to drink more water?

This is a challenge that many parents face. The first step is to cut back on the amount of juice or soda that is offered and consumed. Ideally, cut out soda and dilute juice with water. Limit juice to eight ounces or less per day. Provide your child with their own special bottle or cup. Consider using a special straw that they can pick out for themselves. Infuse the water by adding sliced lemons, limes, cucumber, berries, or mint to make a “spa water.” Keep water cold in the fridge. Try using frozen berries instead of ice cubes. Be a role model and carry a water bottle around for yourself. Offer stickers as an incentive for every time your young child drinks a cup of water. On a typical day, kids up to age 8 should drink the number of 8 oz. cups of water equal to their age. For example, a five-year-old should drink five 8-oz. glasses of water every day.

My child is underweight so I let her snack all day long. This will help her gain weight faster, right?

While some parents assume that their child will gain more weight if they are eating all day long, this is not often the case. For underweight children, there can be a tendency for parents to offer food to the child all day long, as well as allow them to ask for food whenever they want it. This does not allow for natural hunger or appetite to build. Instead, the child grazes on food throughout the day, often eating enough to tame hunger but not enough to truly feel full. The best approach is to follow a feeding schedule with planned meals and snacks every two to three hours. Only water should be consumed in between eating times. This helps build hunger. To help with weight gain, added fats and high calorie foods can be offered or used with meals. Sometimes an oral supplement is needed as well if the child is unable to consume enough food to fuel healthy weight gain. Speak with your child’s pediatrician and a registered dietitian for more individualized advice.

My child says he isn’t hungry in the morning and refuses to eat breakfast. How do I get him to eat?

This is a common challenge for many parents. Often, their child isn’t hungry or doesn’t have enough time to eat before heading off to school. To minimize the morning rush and make time for a healthy breakfast, prepare the night before. Close the kitchen by 8:00 p.m. to prevent unneeded late-night snacking. Make sure that your child goes to bed on time so that it’s easier for him to wake up in the morning. Have quick, healthy options on hand like low-sugar cereals with low-fat milk, fresh fruit and string cheese, whole grain muffins, or whole grain toast with peanut or almond butter. Consider offering non-breakfast foods as another way of enticing your child to eat. For those who don’t want to eat, sometimes drinking a fruit and yogurt smoothie works instead. For teens who skip breakfast in the hopes of losing weight, let them know that people who skip breakfast tend to gain weight, not lose. If all else fails, send your child with a healthy snack to be eaten at school.

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How to Boost Your Child’s Bone Health

Physical activity, calcium and vitamin D are essential for building strong bones, says Dr. Samuel Rosenfeld, orthopaedic surgeon with the CHOC Children’s Orthopaedic Institute. Developing good bone health during childhood helps prevent fractures and osteoporosis later in life.

bone health for kids
Dr. Samuel Rosenfeld, an orthopaedic surgeon at CHOC Children’s, offers tips on how to boost bone health for kids.

Bone is living tissue in the skeleton that constantly changes. Old bone gets replaced with new. The greatest amount of bone tissue grows during childhood and adolescence as the skeleton expands in size and density. It is during this period of active growth when calcium is essential. In addition to requiring a great deal of calcium, the young body absorbs calcium more effectively. For this reason, children need to “bank” extra calcium for bone health.

Some of the most common sources of calcium are from dairy products, such as milk, yogurt and cheese. Note, however, that calcium in dairy products are bound by fat and not absorbed. For that reason, children should get their dietary calcium from fat-free dairy products taken at least one hour away from meals. Other sources include calcium-fortified soy milk and juices, canned salmon (with bones) and sardines, and dark green, leafy vegetables, such as broccoli and kale.

For calcium to be effective in bone growth and development, it is also important that children get enough vitamin D. This can be done through careful sun exposure and eating vitamin D-rich foods such as fortified milk and milk products, cod liver oil, red meat, eggs, mushrooms and some fatty fish.

Calcium and vitamin-D supplements are also important to consider, to ensure children, especially those with certain chronic conditions, are getting enough bone-boosting nutrients. Parents should consult their child’s physician before giving supplements. In this video, Dr. Rosenfeld explains that building healthy bones actually starts while the child is still in the womb, and continues through childhood. Below are Dr. Rosenfeld’s general recommendations:

Age 7 and younger

Calcium intake: 250 mg twice daily

Vitamin D3 intake: 250 IUs twice daily

Ages 8-13

Calcium intake: 500 mg twice daily

Vitamin D3 intake: 500 IUs twice daily

Age 14 and older

Calcium intake: 600 mg twice daily

Vitamin D3 intake: 2000 IUs twice daily

In addition to a calcium and vitamin D-rich diet, children should participate in physical activity, advises Dr. Rosenfeld.

“Ideally, exercise should be part of a child’s daily routine. Parents should help their children find activities and sports they enjoy, so they’ll continue to participate in them,” says Dr. Rosenfeld.

Good bone health is not difficult to achieve and maintain, adds Dr. Rosenfeld.

“It doesn’t take fad pills or fancy supplements,” he explains.
“Establishing a routine of taking calcium and vitamin D, along with a little exercise, is the ‘prescription’ for healthy bones.”

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Year-Round Hydration Tips for the Whole Family

Summer may be around the corner, but hydration is an important part of your family’s health year-round. Keep in mind these easy hydration tips to ensure your family gets the fluid intake they need.

What is dehydration?

Dehydration is a condition that occurs when someone loses more fluids than he or she takes in. Infants and children are especially vulnerable because of their relatively small body weights and high turnover of water and electrolytes. They’re also the group most likely to experience diarrhea, a common cause of dehydration. Vomiting, fever, excessive heat/sweating, and increased urination can also lead to dehydration.

Symptoms of dehydration include:

  • Dry, sticky mouth
  • Sleepiness or tiredness- children are likely to be less active than usual
  • Thirst
  • Decreased urine output
  • No wet diapers for three hours for infants
  • Few or no tears when crying
  • Dry skin
  • Headache
  • Constipation
  • Dizziness or lightheadedness

What does proper hydration look like?

Staying healthy means staying hydrated, since our bodies depend on water to survive. Every cell, tissue and organ in your body needs water in order to work correctly. For example, your body uses water to maintain its temperature, remove waste and lubricate joints. Water is needed for good overall health.

Some of the top beverages I recommended to my patients for hydration include: water, low-fat or fat-free milk, and 100 percent fruit juice.

Keep in mind these tips for choosing healthy beverages:

  • Avoid drinking your calories
  • Avoid drinks that are high in sugar, such as soda, fruit drinks, punch, sweet tea, etc.
  • Choose beverages that have low or no added sugar
  • Remember that water is the source for hydration
  • Read nutrition labels and choose a beverage with less than 6 grams of sugar per serving
  • Be sure to double-check the serving size and number of servings in a bottle.

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Healthy Meal Prep Tips for Busy Parents

By Elise Harlow, registered dietitian at CHOC Children’s

When life gets busy, making homemade meals can fall to the bottom of your to-do list. Drive-through or take-out dinners may sound more appealing and time-friendly! While there is nothing wrong with the occasional fast-food meal, by cooking meals at home you can reduce the amount of added fat and sodium, and have control over the types of ingredients going into your family’s food.

To increase the amount of homemade meals you have on hand during busy times, meal planning and meal prepping can be your best friend. This can also be a great way to involve your kids in the kitchen and increase their interest in healthy foods.

Meal planning: this means taking one day out of the week to sit a down with a planner and plan out your meals for the upcoming week. After your meals are planned out, make a grocery list for all the ingredients you will need for the week.

Helpful tip: use leftovers from dinner for lunch the next day. For example, a roasted chicken for dinner can become a chicken salad sandwich for lunch the next day

How to involve your children: Let your children help you in planning meals by letting them choose what is for dinner one night a week. Maybe one day they can choose a meal that they know they like, and one day they get to pick a new food that they would like to try. You can even bring your children along with you to the grocery store to help pick up the ingredients needed for the week. Children tend to be more likely to try new foods when they have some sort of say in what they are eating.

Meal prepping: this means that once a week you pre-cook whatever meals from your meal plan that allow for this. For example,  roasting a chicken on Sunday and using the chicken in dishes for the rest of the week, or making lasagna on Sunday for dinner during the week, or portioning out yogurt and fruit in single-serving containers for easy grab-and-go breakfasts each day of the week.

How to involve your children: assign your children age-appropriate tasks that they can do on their own. Again, this will increase their interest in the food and could make them more likely to try new foods. Some ideas include scrubbing vegetables, counting ingredients, measuring, or mixing ingredients together.

A crock pot or slow-cooker can be your best friend during busy times. The beauty of a crock pot is that you can throw the ingredients in the crock pot in the morning on your way out the door to work and arrive home to a warm, homemade meal for you and your family. Looking for ideas? Below is a recipe for steel cut oats, that could even be cooked overnight, which means waking up to warm cooked breakfast!

Slow Cooker Steel Cut Oatmeal

Recipe adapted from CookSmarts.com
Ingredients
2 cups steel cut oats
6 cups water

2 cups milk of any type
2 tablespoons butter
2 to 3 peeled apples
¼ cup honey
2 teaspoon salt
1 tablespoon cinnamon
Optional add ins: flax seed, chia seed, almonds, pecans, shredded coconut, hemp seeds, pepitas, etc.

Directions

  1. Spray the slow cooker with cooking oil or brush with cooking oil to prevent sticking.
  2. Put all ingredients into the slow cooker. Cook on low for 8 hours or high for 4 hours.
  3. Top with optional add-ins of your choice.

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Tis the Season for Healthy Holiday Eating

By Lindsay Rypkema, registered dietitian at CHOC Children’s

The holidays are a time filled with family, friends and food. It is important for parents to model good eating habits as well as provide healthful meals and snacks in a season often filled with overindulgence. Eating healthy doesn’t mean you have to forgo all the holiday goodies your family loves, but small modifications can make a big impact. Below are some tips for healthy holiday eating.

  • Snack before you go: Never attend a holiday party hungry! To avoid overeating, consume a light snack at home such as vegetables and hummus or Greek yogurt and fruit. Protein and fiber will keep you full longer.
  • Prepare balanced meals: Choose one item from every food group. Limit the dessert options and always have fresh fruit and vegetables available.
  • Limit sugary drinks: Instead of cider, juice and soda, try infusing water with seasonal fresh fruit such as pomegranate, cranberries or blood orange. Wash fruit, slice and add to water pitcher. You can also use cookie cutters to make holiday shapes.
  • Limit sugar in baking: Baking is a fun holiday tradition but can result in excess calorie and sugar intake. Decrease sugar by 50 percent and add other spices such as vanilla, cinnamon or nutmeg for added flavor. Try replacing the recommended oil with unsweetened applesauce or mashed banana in a 1:1 ratio to decrease calories. This works well in cakes, muffins and breads.
  • Try making a visual and healthy treat: Healthy snacks and desserts don’t have to be boring. For example, you can make a candy cane out of banana and strawberries. Pinterest has some great ideas to make a Santa out of strawberries or a Grinch out of grapes.
  • Get a jump start on your family’s resolutions: Don’t wait until the New Year to increase physical activity. Take a walk or play flag football after your holiday meal. Exercise is an important part of healthy living.
  • Consider simple swaps: Side dishes such as mashed potatoes and stuffing are often a family favorite but can be very high in calories and tempting to overeat. Try offering quinoa in place of stuffing for a healthy, high protein option. Consider using plain Greek yogurt in place of sour cream for added protein. You can also make mashed potatoes out of cauliflower. Try this easy recipe this season:

Cauliflower Mashed Potatoes

2 head cauliflower, cut into florets

2 tablespoon olive oil

1/2 cup Parmesan cheese

2  tablespoons reduced – fat cream cheese

1/4 teaspoon garlic powder

*Salt and pepper to taste

Directions

Steam or boil cauliflower until tender. Mix olive oil, Parmesan, cream cheese, & garlic powder in bowl. Use food processor to blend cauliflower on high. Slowly add your oil/cheese mixture until completely blended. Salt and pepper to taste.

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