Pediatric Nutrition in Practice

130 Malek  Makrides

dine content can vary widely due to a number of
factors including geographical location and envi-
ronmental factors such as the iodine concentra-
tion in the soil. Kelp and seaweed-based products
should be avoided during pregnancy and lacta-
tion due to their large variability in iodine con-
tent.

I r o n

Iron requirements increase in the second and
third trimesters to support fetal growth, placental
tissue development and expansion of the red cell
mass. Intestinal iron absorption increases to meet

increased iron requirements, and reaches peak ef-

ficiency during the third trimester, when the ma-

jority of iron transfer occurs. In iron-sufficient

pregnancies, enough iron is transferred to meet

the infant’s iron requirements for the first 6

months of life. Maternal iron requirements are

reduced during lactation and increase to pre-

pregnancy levels when menstruation resumes.

Haem iron from animal sources is better ab-

sorbed than non-haem iron from plant sources

( table 3 ). Iron absorption from plant foods can be

increased by consuming meat proteins or a source

of vitamin C (e.g. citrus fruits/juices, strawber-

ries, kiwi fruit, tomatoes and broccoli) at the

same meal. Dietary components which can in-

Ta b l e 3. Animal-derived, plant-derived and fortified sources of key nutrients

Animal-derived sources Plant-derived sources Fortified sources

(available in some countries)

Folate Boiled egg yolk Green leafy vegetables, oranges,
orange juice, grapefruit, strawberries,
raspberries, blackberries, sultanas,
yeast spread (Marmite, Vegemite),
legumes, peanuts, sesame seeds,
tahini, sunflower seeds

Bread, breakfast cereals, flavoured

beverage bases (e.g. Milo), milk, soy

beverages, fruit juice

Iodine Fish/seafood, milk, yogurt,
cheese, eggs

Seaweed;

minimal amounts in other sources

Bread, iodised salt

Iron Meat, poultry, fish/seafood
(haem-iron)
Eggs (non-haem iron)

Cooked legumes (chickpeas, lentils,

kidney and lima beans), wholegrain

breads and cereals, nuts, seeds, dried

fruit and green leafy vegetables

(non-haem iron)

Breakfast cereals, flavoured beverage

bases (e.g. Milo; non-haem iron)

Calcium Milk, cheese, yogurt, fish with
bones (e.g. salmon, sardines),
fish paste/spread, crab meat

Amaranth, grain-based foods, green

leafy vegetables, almonds, Brazil nuts,

sesame seeds, tahini, soybeans, firm

tofu, dried fruit

Soy/oat/rice/nut beverages, soy

yogurt, tofu, breakfast cereals,

fruit/vegetable juice, flavoured

beverage bases (e.g. Milo), bread,

edible oil spreads

Vitamin D Oily fish, egg yolks Mushrooms Margarines, milk, powdered milk,
soy beverages, yogurt, cheese, eggs,
breakfast cereals, orange juice

Vitamin B 12 Meat, poultry, fish/seafood,
milk, cheese, yogurt, eggs

None Soy beverages, veggie burgers,

soy-based meat analogues and yeast

extracts (e.g. Marmite)

Zinc Meat, poultry, eggs, milk,
cheese, yogurt, cooked
seafood (especially oysters)

Legumes, wholegrain breads and

cereals, brown rice, soy products

(e.g. tofu and tempeh), nuts, seeds

Breakfast cereals

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 127–133

DOI: 10.1159/000367872