Guidelines Dietary - Eat For Health

Guideline 11.4.4 Infants, children and adolescentsInfants, children and adolescents need sufficient nutritious food to grow and develop normally. The focus should beon maintaining a rate of growth consistent with the norms for age, sex and stage of physiological maturity.Physical growth is best assessed by the conventional measures of weight, length or height, and head circumference(see Appendix H). Maintaining a positive energy balance and adequate nutrient intake is critical in achieving andsustaining normal growth and development. During periods of rapid growth, intentional restriction of weightgain – for example, through dieting – is usually inappropriate.GrowthRelative to their body weight, children’s nutrient and energy requirements are greater than those of adults. 8Children are nutritionally vulnerable up to around 5 years of age, after which their growth rate slows and theirnutritional needs reduce relative to their body size. As a child’s rate of growth is a fundamental indicator ofnutritional status and health and wellbeing, parents, carers and health professionals must be responsive tothe developmental and nutritional needs of children.Between birth and 18 years of age, body weight increases about 20-fold. During infancy and adolescence the rateof growth can change rapidly, while from 12 months of age the rate of increase in weight and length is essentiallylinear. Growth decelerates rapidly during the first year of life. During adolescence it accelerates over 1–3 yearsand then decelerates rapidly until growth in height ceases at about 16 years in girls and 18 years in boys.Childhood is a period of education about eating and good nutrition, so appropriate use of food is important inestablishing healthy nutrition practices for life. Food intake may drop off during the second year of life, whenparents’ encouragement and example may be needed. After starting school, children are subject to an increasingarray of influences from outside the home, particularly peer pressure, which peaks in adolescence.Dietary patterns for achieving and maintaining a healthy weight in infants, childrenand adolescentsFoundation Diets represent the basis of optimum diets for infants, children and adolescents. Sufficient nutritiousfoods must be provided to support optimum growth and development in all children.For the youngest, shortest or least active in each age and sex group, dietary modelling suggests that there isno opportunity for additional energy intake beyond Foundation Diets unless increased physical activity increasesenergy expenditure and requirement. For these children Foundation Diets are equivalent to Total Diets.For older, taller or more active children in each age and sex group, additional serves of foods from the five foodgroups and/or unsaturated spreads and oils and/or discretionary food choices may be made to increase energyintake until energy requirements are met. 9 Growth and weight of children should be checked regularly (as outlinedin Appendix G) and the amount and/or quality of diet and physical activity adjusted accordingly. 9Compared to current intakes, Foundation Diets for infants, children and adolescents include higher quantitiesof vegetables, fruit, wholegrain cereals, poultry, fish, eggs and low fat milk, yoghurt and cheese products, andinclude lower quantities of starchy vegetables, refined grain (cereal) foods, higher and medium fat milk, yoghurtand cheese products. For children, as for adults, decreased consumption of discretionary food choices is neededto achieve the dietary patterns in the Australian Guide to Healthy Eating and companion resources, together witha change from refined grain (cereal) foods to wholegrain cereals and from higher fat to lower fat milk, yoghurt andcheese products for children over 2 years of age.Recommended quantities of specific food groups to suit those preferring a range of dietary patterns are includedin the Foundation Diets for infants, children and adolescents set out in the Food Modelling System. 9Dietary patterns for weight management in children and adolescents who are alreadyoverweight and obeseManagement of overweight and obesity in childhood is recommended to reduce risk of overweight in later life.Individual assessment and clinical supervision is recommended to ensure appropriate growth and developmentwhile managing weight in overweight or obese children and adolescents. As parental overweight or obesityis associated with increased risk of overweight or obesity in children, a family-focused approach to weightmanagement is likely to be beneficial. 176-179 For further information on weight management, see NHMRCOverweight and Obesity Guidelines. 12126EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council