Toddlers, Preschool and School Children 121
2
Heme iron also increases the absorption of iron
from plant food.
Fish is an important source of iodine and
long-chain n–3 fatty acids and should be eaten at
least once a week. Many children only accept
braised and fried fish, which might be high in fat.
To increase the quality of the fat consumed, at
least half of the total fat intake – both ‘hidden’
and visible – should come from plant oils, prefer-
ably those with a high content of mono- and
polyunsaturated fatty acids and which contain
some α-linolenic acid (rapeseed, soy, f laxseed)
and sufficient vitamin E. These oils are practi-
cally free of trans- fatty acids. An overall low fat
use will further reduce the total intake of satu-
rated and trans- fatty acids.
Beverages should preferably be offered to tod-
dlers from a cup and should be free of or low in
energy (water or unsweetened herbal or fruit
teas). Milk is not to be regarded as a beverage but
as a food. Fruit juices can contain valuable vita-
mins and minerals but, if undiluted, are high in
sugars (>10% of weight). Fruit-based beverages,
lemonades and cola beverages often contain large
amounts of sugar and are unsuitable for relief
of thirst. Sugar-sweetened beverages tend to be
overconsumed, which can result in a positive en-
ergy balance and overweight [7–9].Conclusions- Dietary recommendations for toddlers (1–3
years of age) gradually approach those for chil-
dren, adolescents and adults; the percentage of
energy derived from fat should decrease from
40% to around 30%
- Children should be permitted (within reason-
able limits) to determine the amount of food
they consume from a range of basic food groups - Preferences for taste should be respected to a
certain degree
7 Kranz S, Smiciklas-Wright H, Siega-Riz
AM, Mitchell AD: Adverse effect of high
added sugar consumption on dietary
intake in American preschoolers. J Pedi-
atr 2005; 146: 105–111.
8 Ludwig DS, Peterson KE, Gortmaker SL:
Relation between consumption of sugar-
sweetened drinks and childhood obesity.
Lancet 2001; 357: 505–508.
9 Welsh JA, Cogswell ME, Rogers S, Rock-
ett H, Mei Z, Grummer-Strawn LM:
Overweight among low-income pre-
school children associated with the con-
sumption of sweet drinks: Missouri,
1999–2002. Pediatrics 2005; 115:e223–
e229.References1 Young EM, Fors SW, Hayes DM: Asso-
ciations between perceived parent be-
haviors and middle school student fruit
and vegetable consumption. J Nutr Educ
Behav 2004; 36: 2–8.
2 Gidding SS, Dennison BA, Birch LL,
Daniels SR, Gilman MW, Lichtenstein
AH, Rattay KT, Steinberger J, Stettler N,
van Horn L; American Heart Associa-
tion: Dietary recommendations for chil-
dren and adolescents: a guide for practi-
tioners. Pediatrics 2006; 117: 544–559.
3 Kersting M, Alexy U, Clausen K: Using
the concept of Food Based Dietary
Guidelines to develop an Optimized
Mixed Diet (OMD) for German children
and adolescents. J Pediatr Gastroenterol
Nutr 2005; 40: 301–308.
4 Alexy U, Clausen K, Kersting M: Nutri-
tion of healthy children and adolescents
according to the Optimised Mixed Diet
concept. Ernährungsumschau 2008; 3:
169–177.
5 Agostoni C, Decsi T, Fewtrell M, Goulet
O, Kolacek S, Koletzko B, Michaelsen
KF, Moreno L, Puntis J, Rigo J, Shamir
R, Szajewska H, Turck D, van Goud-
oever J; ESPGHAN Committee on Nutri-
tion: Complementary feeding: a com-
mentary by the ESPGHAN Committee
on Nutrition. J Pediatr Gastroenterol
Nutr 2008; 46: 99–110.
6 Hilbig A, Kersting M: Effects of age and
time on energy and macronutrient in-
take in German infants and young chil-
dren: results of the DONALD study.
J Pediatr Gastroenterol Nutr 2006; 43:
518–524.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