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Thursday, June 20, 2013
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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Thursday, June 20, 2013
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Obesity in children has increased so quickly over the past 30 years that it is now thought of as an epidemic. More than 23 million, or 2 out of 3 children and teenagers are either overweight or obese. And rates continue to rise.
Experts agree that diet and exercise play very important roles in your child’s risk for building up unhealthy weight. The American Academy of Pediatrics suggests the following diet and exercise guidelines for children and adolescents. These guidelines are based on evidence from studies that show that they help improve the health of youth.
Prior to Birth
Age Birth to 23 Months Old
Age 2-3 Years Old
Age 4-8 Years Old
Age 9-13 Years Old
Age 14-18 Years Old
If you are pregnant, your diet is very important to both you and your growing baby. Your diet directly affects your baby’s health in both the short- and long-term. We now know that too many or too few calories during pregnancy can increase your baby's risk for several health problems later in life, including:
So during pregnancy, it is important to:
Use the chart below to find out how much weight you should gain based on your pre-pregnancy weight body mass index (BMI).
| Pre-pregnancy BMI |
Recommended total pregnancy weight gain |
|---|---|
|
Underweight: pre-pregnancy BMI less than 19.8 |
28-40 pounds |
|
Normal weight: pre-pregnancy BMI 19.8-26.0 |
25-35 pounds |
|
Overweight: pre-pregnancy BMI 26.0-29.0 |
15-25 pounds |
|
Obese: pre-pregnancy BMI greater than 29.0 |
15 pounds at most |
Institute of Medicine. Nutrition During Pregnancy. Washington DC: National Academy of Sciences; 1990.
Fighting obesity must start early. Building up too much baby fat can increase the risk of your child becoming fat later in life.
During the first year of life, the focus should be on the unique nutritional needs of each specific growth period. Your child's health care provider should closely monitor your child for appropriate growth and weight gain. Introduce family mealtime once your child begins to eat table foods at around 6-9 months of age. Children who eat meals with the family are less likely to be obese.
Exercise should generally be focused on unstructured, safe play environments. Activities that promote free movement and development, such as providing tummy time for an infant, are important at this stage.
Following safe sleeping guidelines is also important during this period of a baby’s life. Risk of SIDS (Sudden Infant Death Syndrome) is highest during the first 12 months after birth. To reduce this risk:
Human milk is superior. Try to rely mainly on breastfeeding or pumping to supply your baby with bottles filled with breast milk. Feed anytime your baby is hungry. Try to continue breastfeeding for 12 months.
If you must use formula, however, follow these guidelines:
On average, a baby should drink 2.5 ounces of formula for each pound they weigh every day. For example, a 10-pound baby should drink 25 ounces of formula each day.
Start other sources of nutrition:
Introduce healthy foods like:
Continue to offer these foods even if your baby initially refuses them.
Wait until your baby is at least 6 months of age before offering 100% juice. Limit juice to no more than 4-6 ounces per day, and offer it only with a meal or snack.
When your baby is 12 months old, you may give him or her whole cow’s milk. At that time, limit the amount of milk your bab
y drinks to 32 ounces each day.
Continue to introduce healthy foods like:
Offer these foods even if your baby initially refuses them. Do not introduce foods without any nutritional value simply to provide extra calories. Limit salt/sodium intake to less than 1500 mg per day.
Give juice in a cup only – not a bottle. Make eating a social event for the family by establishing regularly scheduled meals together. Do not overfeed or force your child to finish meals if he or she is not hungry.
If you are concerned about your baby becoming obese, discuss this with your baby’s doctor. Do NOT put a baby younger than 2 years old on a diet or restrict their calories and dietary fat intake.
Recommended Overall Dietary Intake for a One Year Old |
|
900 calories each day (no differences between boys and girls)
Must include:
Additional calories should be used as carbohydrates. *For example, one piece of whole grain bread = 1 ounce |
Provide a safe, nurturing, minimally structured play environment for your child to participate in daily.
Allow infants/toddlers to explore the outdoors with supervision so they can develop an enjoyment of the outdoors. Activities include:
He
althy nutrition for toddlers should focus on eliminating excessive snacking as well as providing healthy snack choices that do not include too many calories. Junk food often has extra calories.
You might notice that your toddler’s appetite has dropped. This is usually okay since growth rates have slowed. Your toddler might not need as much food as he or she did as a baby. Parental modeling of appropriate eating behavior is also important at this age during family meal times.
Focus exercise to allow for your child’s continued development and safe exploration outdoors.
Nutrition Recommendations for 2-3 Years Old:
Eat regularly scheduled family meals together, and make them social events for the family. This will promote social interaction and give you a chance to role model positive food-behavior.
Provide meals with a variety of choices of fruits and vegetables instead of ice cream, salty snacks, fried foods, and cookies.
Avoid or limit sweet/sweetened beverages such as soda, juice, sports drinks to a maximum of 4-6 ounces each day, if given. Also try to avoid these beverages as snacks.
Recommended Overall Calorie Intake for 2-3 Years Old |
|
1000 calories each day (no differences between boys and girls)
Must include:
Additional calories should be used as carbohydrates. *For example, one piece of whole grain bread = 1 ounce. |
Parents should provide a safe, nurturing, minimally structured play environment for the child to participate in daily.
Children younger than 2 years old should not watch any TV.
Toddlers should be allowed to explore the outdoors with supervision to help them develop an enjoyment for the outdoors. Activities include:
During young school ages, family meal times continue to be important, especially with regard to parental modeling. Additionally, following through with reduced snacking and healthy food choices remain key ways to encourage proper nutrition.
Organized play and participation in simple sports or dance activities become new ways to incorporate exercise. If it is not possible for our child to be in organized activities, consistent organized play should be enforced so that your child begins to learn the habit of regular exercise. Free play each day is also important, however, and should be added into your child’s daily schedule.
Eat regularly scheduled family meals together, and make them social events for the family. This will promote 
social interaction and give you a chance to role model positive food-behavior.
Continue to offer a variety of healthy foods even if your child is a picky eater.
Avoid or limit sweet/sweetened beverages such as soda, juice, sports drinks to a maximum of:
Also try to avoid these beverages as snacks.
Recommended Overall Calorie Intake for 4-8 Years Old |
|
| 1400 calories each day for boys | 1200 calories each day for girls |
Must include:
Additional calories should be used as carbohydrates. |
Must include:
Additional calories should be used as carbohydrates. |
Encourage at least 60 minutes per day of free play with an emphasis on:
Co-ed activities that include both girls and boys are suitable, since there is little difference between the sexes in weight, height, endurance, and motor skills. Appropriate activities include:
Ensure proper safety and adult supervision.
Encourage your child to participate in 30 minutes of adult-led activity per day. Expect a pre-school aged child to walk reasonable distances with family members.
Limit to less than 2 hours per day:
Physical activity should occur a minimum of 60 minutes per day, 7 days each week and should include:
Co-ed activities that include both girls and boys are suitable since there is little difference between the sexes in weight, height, endurance, and motor skills.
Competitive organized sports – such as soccer, baseball – may be introduced at this time but with the following conditions:
Encourage free play that involves learning new physical skills with proper safety and adult supervision. TV time should be limited to 2 hours or less per day. Encourage:
With the onset of puberty during middle school years, nutritional requirements start to differ between boys and girls. Your job as a parent is to monitor what your child eats; your child’s job is to determine how much to eat. Having healthy snacks and meals available at home when your child is hungry will help them learn how to make healthy choices. Having them assist with the shopping and preparation of meals and snacks is another way to encourage good decisions about foods.
Options of regular exercise include involvement in more complex sports as well as supervised weight/strength training. An emphasis on enjoyment of regular exercise is important at this age.
Eat regularly scheduled family meals together, and make them social events for the family. This will promote social interaction and give you a chance to role model positive food-behavior.
Provide meals with a variety of choices of fruits and vegetables instead of ice cream, salty snacks, fried foods, and cookies.
Avoid or limit sweet/sweetened beverages such as soda, juice, sports drinks to a maximum of 8-12 ounces each day.
Recommended Overall Calorie Intake for 9-13 Years Old: |
|
|---|---|
|
1800 calories each day for boys |
1600 calories each day for girls |
Must include:
Additional calories should be used as carbohydrates. *For example, one piece of whole grain bread = 1 ounce. |
Must include:
Additional calories should be used as carbohydrates. *For example, one piece of whole grain bread = 1 ounce. |
|
|
|
Encourage activities that focus on physical skill development and understanding of sports tactics. These activities should occur a minimum of 60 minutes every day, 7 days each week.
Nutritional requirements differ between boys and girls during adolescence due to pubert
y differences. Your job as a parent is to monitor what your child eats; your child’s job is to determine how much to eat. Having healthy snacks and meals available at home when your child is hungry, or having them assist with the shopping and preparation, will help them learn how to make healthy choices. This remains the most important nutritional influence in the home.
Exercising options are similar to that of adults except for caution regarding heavy weight training in those adolescents who have not completed their growth.
Eat regularly scheduled family meals together, and make them social events for the family. This will promote social interaction and give you a chance to role model positive food-behavior.
Provide meals with a variety of choices of fruits and vegetables instead of ice cream, salty snacks, fried foods, and cookies.
Avoid or limit intake of sweet/sweetened beverages such as soda, juice, sports drinks to a maximum of 8-12 ounces each day.
Recommended Overall Calorie Intake for 14-18 Years Old |
|
|---|---|
| 2200 calories each day for boys | 1800 calories each day for girls |
Must include:
Additional calories should be used as carbohydrates.
*For example, one piece of whole grain bread = 1 ounce. |
Must include:
Additional calories should be used as carbohydrates.
*For example, one piece of whole grain bread = 1 ounce |
Encourage activities that focus on your teen's individual idea of fun and on his/her enjoyment with friends. Activities should occur a minimum of 60 minutes every day, 7 days each week and can include the following:
Aerobic activity should occur daily, including vigorous-intensity activities such as:
Weight training:
Points to Remember:
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References
American Academy of Pediatrics: healthychildren.org. Accessed: http://www.healthychildren.org/English/agesstages/gradeschool/nutrition/pages/Cooking-With-Your-Children.aspx
American Heart Association. Gidding et al. 2006 Dietary Recommendations for Children and Adolescents: A Guide for Practitioners. Pediatrics. Feb; 117(2): 544-559. Accessed: http://pediatrics.aappublications.org/content/117/2/544.full.pdf+html?sid=3bbf2e40-be42-4056-b18c-d70e7e089ebb
Barker DJP, Osmond C. 1986 Infant mortality, childhood nutrition, and ischemic heart disease in England and Wales. Lancet: 1: 1077-1081.
Dyer JS, Rosenfeld CR, Rice J, Rice M, Hardin DS. 2007 Insulin resistance in Hispanic Large For Gestational Age neonates at birth. J Clin Endocrinol Metab. Oct; 92 (10): 3836-3843.
Eriksson JG, Forsen TJ, Osmond C, Barker DJ. 2003 Pathways of infant and childhood growth that lead to type 2 diabetes. Diabetes Care 26 (11): 3006-3010.
Institute of Medicine. Nutrition During Pregnancy. Washington DC: National Academy of Sciences; 1990.
National Center for Health Statistics. Health, United States, 2006. www.cdc.gov/nchs/hus.htm; accessed December 2007.
The American Academy of Pediatrics Policy Statements.
US Department of Agriculture & US Department of Health and Human Services. 2010 Dietary Guidelines for Americans. Accessed: http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/PolicyDoc.pdf
US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans: Chapter 3: Active Children and Adolescents. Accessed: http://www.health.gov/paguidelines/guidelines/chapter3.aspx
This article was originally written by Dr. Jennifer Dyer, MD.
Ashley Lucas, PhD, Dietetic Intern, The Ohio State University, assisted in the current review of this content.
This article is a NetWellness exclusive.
Last Reviewed: Jun 14, 2013
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Carolyn Gunther, PhD Assistant Professor of Human Nutrition College of Education and Human Ecology The Ohio State University |
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Please note: only your personal physician or other health professional you consult can best advise you on matters of your health based on your medical history, your family medical history, your medication history, and how information from any of these databases may apply to you. Neither University of Cincinnati (NetWellness) nor any party involved in creating, producing or delivering this web site shall be liable for any damages arising out of access to or use of this web site, or any errors or omissions in the content thereof. (More) 
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