EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

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Guideline 1

1.4.4 Infants, children and adolescents

Infants, children and adolescents need sufficient nutritious food to grow and develop normally. The focus should be

on 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 and

sustaining normal growth and development. During periods of rapid growth, intentional restriction of weight

gain – for example, through dieting – is usually inappropriate.

Growth

Relative to their body weight, children’s nutrient and energy requirements are greater than those of adults.^8

Children are nutritionally vulnerable up to around 5 years of age, after which their growth rate slows and their

nutritional needs reduce relative to their body size. As a child’s rate of growth is a fundamental indicator of

nutritional status and health and wellbeing, parents, carers and health professionals must be responsive to

the developmental and nutritional needs of children.

Between birth and 18 years of age, body weight increases about 20-fold. During infancy and adolescence the rate

of growth can change rapidly, while from 12 months of age the rate of increase in weight and length is essentially

linear. Growth decelerates rapidly during the first year of life. During adolescence it accelerates over 1–3 years

and 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 in

establishing healthy nutrition practices for life. Food intake may drop off during the second year of life, when

parents’ encouragement and example may be needed. After starting school, children are subject to an increasing

array of influences from outside the home, particularly peer pressure, which peaks in adolescence.

Dietary patterns for achieving and maintaining a healthy weight in infants, children

and adolescents

Foundation Diets represent the basis of optimum diets for infants, children and adolescents. Sufficient nutritious

foods 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 is

no opportunity for additional energy intake beyond Foundation Diets unless increased physical activity increases

energy 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 food

groups and/or unsaturated spreads and oils and/or discretionary food choices may be made to increase energy

intake until energy requirements are met.^9 Growth and weight of children should be checked regularly (as outlined

in Appendix G) and the amount and/or quality of diet and physical activity adjusted accordingly.^9

Compared to current intakes, Foundation Diets for infants, children and adolescents include higher quantities

of vegetables, fruit, wholegrain cereals, poultry, fish, eggs and low fat milk, yoghurt and cheese products, and

include lower quantities of starchy vegetables, refined grain (cereal) foods, higher and medium fat milk, yoghurt

and cheese products. For children, as for adults, decreased consumption of discretionary food choices is needed

to achieve the dietary patterns in the Australian Guide to Healthy Eating and companion resources, together with

a change from refined grain (cereal) foods to wholegrain cereals and from higher fat to lower fat milk, yoghurt and

cheese products for children over 2 years of age.

Recommended quantities of specific food groups to suit those preferring a range of dietary patterns are included

in the Foundation Diets for infants, children and adolescents set out in the Food Modelling System.^9

Dietary patterns for weight management in children and adolescents who are already

overweight and obese

Management 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 development

while managing weight in overweight or obese children and adolescents. As parental overweight or obesity

is associated with increased risk of overweight or obesity in children, a family-focused approach to weight

management is likely to be beneficial.176-179 For further information on weight management, see NHMRC

Overweight and Obesity Guidelines.^121