Pediatric Nutrition in Practice

Toddlers, Preschool and School Children 119

2

Principles of Children’s Diets and Eating

Food-based dietary guidelines based on the en-
ergy and nutrient needs of children, on children’s
preferences as well as on health aspects provide
advice on food selection, meal composition and
meal patterns, including recipes. The main food
groups included are of high nutrient density: ce-
reals and other starchy foods (bread, pasta, pota-
toes, etc.); vegetables, legumes and fruits; milk
and dairy products; meat, poultry, eggs and (oily)
fish; and fats and oils.
A list of reference amounts of the main food
groups, which provide ≥ 90% of the appropriate
energy intake and 100% of practically all micro-
nutrients, is part of OptimiX ( table 1 ) [3, 4]. In
addition, <10% of the energy intake is provided
by ‘tolerated’ food groups, often of low nutrient
but high energy density. These foods are not
prohibited but permitted to meet, for instance,
the preferences for sweets of some children and

to permit f lexibility in the composition of

meals. The amounts of foods are guidance val-

ues, with the possibility of choosing within a

food group – e.g. instead of milk and milk prod-

ucts, cheese can be consumed, based on their

equivalency in calcium content (100 ml of milk

correspond to about 15 g of hard or 30 g of soft

cheese). The amounts shown in table 1 need not

to be consumed every day; the aim should be

the average amount consumed per week. Vari-

ability in daily intake is normal; in children, the

variability in daily energy intake can be 50%

around the average. Moreover, small and inac-

tive children will eat smaller amounts than ac-

tive and big children, and boys will consume

more than girls of the same age. From the start,

children should be allowed to determine the

amounts they wish to eat and not be forced to

empty their plates. This will permit them to eat

to satiety and help to avoid overnutrition and

overweight.

Ta b l e 1. Example of adequate amounts of foods to be consumed per day at different ages

Age, years 1 2 – 34 – 67 – 910 – 12

Total energy, kcal/day 850 950 1,250 1,600 1,900

Recommended foods (≥90% of total energy)

Generously

Beverages, ml/day 600 700 800 900 1,000

Vegetables, g/day 120 150 200 220 250

Fruit, g/day 120 150 200 220 250

Potatoes, pasta, flakes, rice, etc., g/day 100 120 150 180 220

Moderately

Milk, milk products, ml or g/day 300 330 350 400 420

Meat, meat products, g/day 30 35 40 50 60

Eggs, n/week 1 – 21 – 2222 – 3

Fish, g/week 25 35 50 75 90

Sparingly

Oil, butter, margarine, g/day 15 20 25 30 35

Tolerated foods (≤10% of total energy)

Cake, sweets, jam, sugar, etc., max. kcal/day 85 95 125 160 190

Modified 2013 from Kersting et al. [3] and Alexy et al. [4] according to the most recent dietary re-

ference values.

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 118–121
DOI: 10.1159/000360329