Top questions from parents about nutrition
Good nutrition is important for a healthy life. As a parent, you might have questions about nutrition for your kids, including questions about celiac disease, food allergies or tips for your picky eater. Here are the answers to parents top nutrition questions:
1. My child hates fruits and vegetables. How can I get them to eat healthier?
Most children should aim for at least two fruit and two vegetable servings every day. A general rule is that one serving size is equal to the size of the child’s fist. Half of your child’s plate at each meal should be fruits and vegetables. Download this healthy eating place mat (.pdf) to help them see how much they should be eating.
Growing children need certain vitamins and minerals to be as healthy as possible. Fresh vegetables and fruit provide these nutrients and your child should eat them every day. If your child is overweight, it is especially important to include vegetables and fruit in their diet because they are naturally low in calories.
To help your child learn to love eating fruit and vegetables:
- Serve them with every meal, starting with the fruit and vegetables your child already likes.
- Introduce new vegetables and one fruit one variety, one serving at a time.
- Teach your child descriptive words like “I like this because it’s crunchy” or “This is too mushy” to help you prepare veggies and fruit in the future.
- Make vegetables and fruit more appealing by cutting them into shapes with cookie cutters or a spiralizer.
- Set a good example by eating plenty of vegetables and fruit yourself.
- Add veggies to pastas, rice dishes, casseroles and soups; add fresh fruit slices to cereal and yogurt.
- Make vegetables and fruit easier to reach by placing them at eye level on the counter and in the fridge.
- Take your child shopping with you and encourage them to pick out a fruit or vegetable they’ve never had before – consider doing a taste test together.
- Stop preparing a different meal after your child rejects the original – this only encourages picky eating.
- Stop serving snacks several hours before a meal – your child will be more adventurous at meal times if they are hungry.
- Be creative about presenting foods in different ways – serve shredded carrots or frozen peas instead of cooking them.
- Incorporate vegetables and fruit into your daily eating routines – don’t make a big deal about it and be patient. If you’re consistent, your child will eventually get used to it.
Read more about getting fruits and vegetables into your family’s diet.
Source: Deidra Barlow RD CSP
2. Should I let my child snack throughout the day or limit their eating to just mealtimes?
If you are letting your child snack whenever they want, you are sending them mixed signals about hunger and fullness. Kids will often reach for a snack when they’re bored, tired, frustrated or even thirsty. Using food to “feel better” instead of eating to satisfy hunger and nutritional needs is a habit that will be hard for your child to break as they grow up.
Plan snacks just like you would a meal. If your child eats lunch at 11:30 a.m., but dinner isn’t ready until 6 p.m., then by all means, give them an afternoon snack. If it’s close to their next meal and your child is asking for food, figure out if they are just bored or tired before automatically handing over a granola bar. It’s ok to explain to your child that there are times we eat and times we don’t, and let them know when the next meal time is.
Source: Helen Seagle, MS RD
3. I’m busy and don’t have time to prepare healthy meals for my children. What are some quick and easy healthy snacks and meal ideas?
You’re not alone— parents are busier than ever these days, and there are tons of resources and ideas out there to try.
- The experts at Children’s Colorado have created several easy, healthy, family-approved recipes.
- Consider making a meal plan for the week to help you stay organized and save time.
- Keep your pantry, refrigerator and freezer stocked with healthy foods so you are prepared to put a simple, healthy meal together quickly.
- Search for recipes that are “one-pot” or “crockpot”— these are designed to reduce your cooking time.
- It doesn’t have to be complicated— throw some tomato and avocado slices onto a piece of whole-grain bread, sprinkle lightly with some cheese and pop it into the toaster oven for a few minutes; make cucumber sandwiches with sliced cucumbers and hummus or cheese; spread 2 tablespoons of nut butter onto a whole-wheat tortilla, add a banana, roll it and slice it up.
- No matter what you end up serving, if you include fiber from sources like vegetables, fruits, whole grains and legumes, low- or non-fat dairy or protein, you can feel good about what you’re serving your child.
Step back and think about your family’s health – it’s a huge priority, even in the midst of your busy life. Eating family meals together – at home, at the dinner table, at the same time everyday, with the TV and phones off, is a ritual that’s worth a tradeoff somewhere else in your life.
Source: Jessica Hildebrandt MS RD CSO
4. What can I order at a fast-food restaurant that’s relatively healthy for my child?
It may be impossible to avoid fast food or eating out, but if you come within a mile of a restaurant while your family is hurried and harried, chances are you’re not going to make the best choices.
- Take a few minutes to determine the restaurants you use most often, or the ones that are closest to your home and work.
- Read through their nutrition information and pick out a few lower-calorie items from each location.
- These are now your go-to order items. The next time you’re waiting in a drive-thru line or confronted with a huge menu while you’ve got cranky kids in tow, you won’t have to think about it— you’ll automatically order a healthy option for them.
Some other general rules to follow when ordering out:
- Order a single sandwich or entrée; avoid the soda, fries, chips and other “value” items.
- Always order water instead of soda.
- Order small sizes or off the kids’ menu.
- Ask for the sauce, mayo or dressing to be removed, or on the side.
- French fries or chips will never be healthy; if you must have them, order only one and split it between the entire family.
Source: Helen Seagle, MS RD
5. I pack healthy lunches for my child and feed them nutritious food at home, but well-meaning grandparents, friends, parents and teachers often offer my child fruit juices, sodas, chips, candy or cookies. What can I do?
It depends on how involved the person is in your child’s life. If it’s only once in a while, it’s probably not worth the fuss, since a few “bad” foods here and there won’t have a big impact on your child’s health.
If this person interacts with your child on a regular basis, you’ll need to explain your goals to them and ask them to support you. If your child sees them daily or weekly, chances are they are pretty invested in your child’s wellness and would rather be a collaborator than a saboteur.
Another tip: See if your child’s school has a wellness committee you can join. Wellness committees are designed to make schools healthier. Or, meet with teachers and other parents to brainstorm ideas for non-food rewards.
Source: Helen Seagle, MS RD
6. How can I get my kids to drink more water instead of soda, energy drinks and juices?
Sodas, juices and sports drinks are full of added sugars that your child doesn’t need. Limit soda and juice to one small serving (4-6 ounces) on special occasions only. Energy drinks are not appropriate for kids either because they contain harmful levels of caffeine, stimulants and “megadose” vitamins. Sports drinks are only appropriate if your child is participating in continuous exercise that lasts more than one hour or is in a sports tournament.
Water is the best choice because it quenches thirst, is calorie-free and if you’re drinking it from the tap, it’s fortified with fluoride, which helps your child develop strong teeth and bones.
Keep a sippy cup of water or a water bottle within your child’s reach for when they’re thirsty, order water instead of soda at restaurants, and offer water or milk only as options for a beverage at mealtimes. You can also offer your child a straw or freeze berries into ice cubes or add orange slices to make drinking water more “fun.” Be a good role model by drinking your own water throughout the day, and eventually your family will get used to the water-only routine.
Read more about saying no to sugar-sweetened drinks.
Source: Laura Watne MS RD
7. How do I read food labels?
Nutrition labels can be confusing, but once you master them, choosing healthy foods will be much easier:
- Limit your child to the serving size. A serving size is the recommended amount a person should eat, but most packages contain a lot more than one serving. A serving size from a bag of chips bought at the gas station may contain 150 calories and eight grams, but there might be three to four serving sizes in that one bag.
- Choose products with five percent of Daily Value or less in the saturated fat column.
- Keep sodium low by choosing foods that have 20 percent of Daily Value or less in the sodium column.
- Reduce added sugars in your child’s diet by avoiding foods with sugar, high fructose corn syrup, corn syrup/sweetener, cane sugar, fructose, maltose, glucose or maple sugar listed in the ingredients.
Source: Jennifer Kintner MD RD CSP
8. How do I figure out if my child is overweight?
The Centers for Disease Control and Prevention (CDC) has a Body Mass Index Calculator for children and teens, aged two through 19. This tool can help you figure out your child’s weight category. If you’re concerned about your child’s weight, make an appointment with your primary care physician or get treatment at Children’s Colorado’s Weight Management Program. A health care provider will be able determine if your child’s weight is healthy, review their growth chart and make recommendations.
Source: Renee Porter, CPNP-PC
9: My child is overweight and wants to go on a diet – should I allow him/her to do this?
No – diets do NOT work. Children and teens can be prompted to be more active and to eat a wider variety of foods. You can work with them on “mindful” eating to pay attention to their body cues. Dieting tends to lead to unhealthy relationship with food and children are more likely to develop unhealthy eating habits and get stuck in a negative cycle if they go on specialized diets. Brandon, a patient at Children’s Colorado, shares his story of getting healthy.
The focus should not be on losing weight, but on being healthy. Focusing on losing weight only could lead to additional issues, such as eating disorders. If you do suspect your child might have an eating disorder, watch this series of videos where our patient, Madi, candidly shares her teen perspective about being treated in Children's Hospital Colorado's Eating Disorders Unit for bulimia.
10. How can I help my child if they are being bullied or made fun of about their weight?
Bullying is a serious issue that turns an innocent child into a victim. Twenty percent of school-aged children are bullied and this increases to 60 percent if the child struggles with obesity. Putting your child on a diet or changing the way they eat is not a solution to bullying. Read more about bullying here.
It is hard, but you’ll have to talk with educators or other parents resolve bullying issues. Meanwhile, listen to your child’s concerns and let them know you support them. Make it clear to your child that they can feel good at any size. Make sure they have clothing that fits, get them involved in the activities they’re interested in, encourage friendships and acknowledge their changing behaviors.
If you’re concerned about your child’s weight, talk with your pediatrician or consider getting treatment at Children’s Colorado’s Weight Management Program.
Source: Helen Seagle, MS RD
11: How do I make sure my child, who is very active in sports, is eating enough?
You need to make sure your child is eating enough to support growth and appropriate weight gain and when he/she is very active, and that sometimes requires you to pay closer attention to how much he/she is eating. Sometimes kids will be hungrier when active, but sometimes heavy activity actually makes kids have less of an appetite. In general, kids should eat 5-6 times per day. More active kids should eat larger, more nutritionally dense snacks in between meals.
The right foods and drinks can help your child as an athlete. Read more about the nutrition needs of athletes and how your child should be eating before playing sports.
12: My friend’s child has celiac disease and thought my kid might, too. What exactly is celiac disease, and what are the symptoms?
Celiac disease is an autoimmune disorder that causes injury to the small intestine. It occurs when someone born with a genetic risk develops an immune reaction to dietary gluten. Gluten is a protein that comes from wheat, rye and barley, and is found in many foods.
The symptoms for celiac disease are different for different people. Some children may grow poorly and can be very sick with vomiting, diarrhea, abdominal pain and irritability. Other children may have no symptoms and may not have go to the doctor unless they know they have a genetic risk and want to be screened.
Watch this helpful video about celiac disease, or learn how we diagnose and treat it through the Colorado Center for Celiac Disease at Children’s Colorado.
13: If my child has a food allergy, would we see a reaction immediately?
Not necessarily. IgE-mediated food allergy symptoms can be immediate, typically occurring within minutes up to 2 hours after exposure. The most common IgE-mediated food allergens are milk, eggs, soy, wheat, peanuts, tree nuts, fish, shellfish. (Note: IgE is an antibody. We make other antibodies that are part of the immune system and protect us from getting sick; for example, when we get a tetanus vaccine, we make IgG antibodies that protect us in the future from a tetanus infection. When IgE antibodies are made to a food, they can cause usually rapid onset allergic reactions including hives, swelling, or anaphylaxis.)
Learning how to recognize an allergic reaction will help you get your child the medical care needed if a reaction occurs. Symptoms might include a runny nose; an itchy skin rash; a tingling in the tongue, lips, or throat; swelling; stomach pain; or wheezing.
A serious allergic reaction with widespread effects on the body is known as anaphylaxis. This sudden, potentially life-threatening allergic reaction that requires epinephrine include:
- A sensation of tightness in the throat
- Difficulty breathing
- Any symptoms from two or more of the body systems, such as hives and stomach pain, or any other combination of two or more symptoms that affect different parts of the body
Other types of food allergy, called non-IgE mediated food allergy, can have delayed reactions occur more than 2 hours after ingestion. A common non-IgE mediated food allergy is call food protein-induced entercolitis (FPIES). Patients with FPIES most often develop severe vomiting and/or diarrhea 2-4 hours after food ingestion. Another example of a non-IgE mediated food allergy is celiac disease.
See more about the signs and symptoms of food allergies and check out this helpful infographic about food allergies. If your child has a food allergy, make sure they are prepared to stay safe at school as well.
Learn more about food allergies and how the pediatric experts at Children’s Colorado can help.
14: Should I wait to introduce certain foods to my baby to avoid food allergies?
It’s most important to introduce a baby to new foods gradually, one at a time. If not, you may have trouble tying an allergy to a specific new food.
The type of food or the order in which food is introduced is not much of a concern, as long as the foods you are offering are healthy and well-balanced for the baby. Each time you offer a new food, you should wait three to five days before giving him/her a new food. Don’t eliminate the other foods your baby is eating during that time; you already know these are safe because the child has not had any food reactions up until now. Just don’t add anything else new.
There are new recommendations on when to introduce some of the major food allergens (milk, egg, soy, wheat, peanut, tree nuts, fish, shellfish) into a child’s diet. Introducing these foods as new foods are recommended earlier than previously, as there have been studies showing that earlier introduction (before ages 2-3 years) may prevent the development of food allergy. Some patients with eczema or who have had allergic reactions to a food previously should see an allergist before introducing these foods though.
If you’re introducing a new food to your baby, keep an eye out for these symptoms:
- Hives or welts
- Flushed skin or rash
- Face, tongue, or lip swelling
- Vomiting and/or diarrhea
- Coughing or wheezing
- Difficulty breathing
- Loss of consciousness
Some infants may not tolerate certain milk or soy formulas. If you think that your child is not tolerating a formula or you think that your child may have milk or soy allergy, talk with your doctor about testing and alternatives to milk or soy-based formulas. Breastfeeding your child can lower his/her risk of developing a milk allergy over those who are formula fed.