Elizabeth M. Ward, MS, RD
Kathleen M. Zelman, MPH, RD, LD
America's children are missing out on four essential nutrients -- vitamin D, calcium, fiber, and potassium -- according to the U.S. government's proposed new dietary guidelines.
Are your kids getting enough of these vital nutrients? Here's what they do for your child, how much your child needs, and how to get them into your child's diet.
Vitamin D is the hottest vitamin on researchers' radar these days -- and most people don't get enough of it.
A shortfall of vitamin D has been linked to adult conditions including osteoporosis, breast cancer, colon cancer, prostate cancer, heart disease, and depression. It's not yet clear if vitamin D prevents those conditions, but vitamin D deficiency is becoming more of a concern than in the past.
Experts agree that vitamin D is needed to absorb calcium and maximize bone growth and strength. Kids who get too little vitamin D can develop soft bones, a condition called rickets, early in life, and osteoporosis, which typically shows up later in life.
How much vitamin D to get: The AAP recommends getting a minimum of 400 international units (IU) of vitamin D per day. Another organization, the Institute of Medicine (IOM), which sets the U.S. government's official nutrient recommendations, has also revised its vitamin D guidelines upward. In its November 2010 guidelines, the IOM recommends a daily dietary allowance [RDA] for vitamin D at a higher daily value of 600 IU for children between 1-18 years old.
Increasing vitamin D: The body makes vitamin D when exposed to strong sunlight, storing extra for future use. Common foods rich in vitamin D include most milk and other fortified foods, such as some brands of breakfast cereals, orange juice, and yogurt. Other foods rich in vitamin D include fattier fish, such as salmon and light tuna.
Supplements are another source of vitamin D. The AAP specifies that children who don't drink a quart of milk fortified with vitamin D take vitamin D supplements to make up for what they miss from their diet.
Calcium is best known for helping bones grow and stay strong. It also helps with heart rhythm, blood clotting, and muscle function.
Most calcium is stored in bones. If your child doesn't get enough calcium in their diet, the body will steal it from their bones.
How much calcium to get: Here are the IOM's daily calcium recommendations for children:
Many U.S. children, especially teens, get far too little calcium -- and those are crucial bone-building years.
"Soft drinks, such as soda and fruit beverages, have infiltrated kids' diets, causing milk to take a back seat," says Jodie Shield, MEd, RD, co-author of the American Dietetic Association's Guide to Healthy Eating for Kids, and mother of three.
Girls may be at particular risk. One study showed that adolescent girls average 814 milligrams a day vs. the recommended 1,300. That may make them more likely to get osteoporosis later on.
"Just before the teen years, and all throughout adolescence, children must get enough calcium to provide the foundation for strong bones," says Shield. "During this time, the body lays down nearly half of all the bone mass it will ever have."
Increasing calcium: Shield suggests offering children low-fat or flavored milks instead of other beverages that offer little more than calories. Including dairy at every meal also ensures that children meet their calcium goals.
Count on getting 300 milligrams of calcium from 8 ounces of any type of milk (including lactose-free) or yogurt, or from 1.5 ounces of hard cheese (such as cheddar).
Orange juice with added calcium and vitamin D is a calcium-rich, but dairy-free, option. Children who don't get enough dairy or fortified choices may need a calcium supplement.
On-the-go lifestyles are one reason why kids are eating less fiber than they should. A lack of fiber-filled whole grains and fresh and lightly processed fruits and vegetables -- foods typically eaten at home -- is largely to blame.
"I'm a dietitian and getting my own kids to eat enough fiber is challenging," Shield says.
Fiber helps curb constipation by adding bulk to bowel movements, stimulating the gut to pass waste with greater ease. Fiber also helps kids feel fuller, a handy weapon in the battle of the bulge.
When part of a balanced diet, fiber helps head off type 2 diabetes and high cholesterol in adults, and may work for kids, too. Diets rich in fiber-filled foods may cut the risk of heart disease later in life.
In general, high-fiber foods are packed with vitamins and minerals to fuel growth and development. They also contain beneficial plant compounds called phytonutrients that boost a child's immunity.
How much fiber to get: That depends on your child's age, according to the AAP.
Figure your child's daily fiber quota in grams by adding five to his age. For example, a 5-year-old should get 10 grams of daily dietary fiber.
Increasing fiber: Boost your family's fiber intake by serving a fruit or vegetable (or both) with meals and snacks. Opt for whole-grain breads and cereals, pasta, and other grains.
Also, try to include legumes, including chickpeas, lentils, and white beans in salads, soups, and omelets. Coincidentally, many of these same foods provide potassium and magnesium, too.
Potassium insures normal heart and muscle function, maintains fluid balance, participates in energy production, and promotes strong bones.
A potassium-rich diet helps head off high blood pressure in adults. Getting children in the habit of eating high-potassium foods may help them keep blood pressure in check as they age, too.
But too many children don't get enough potassium.
"Kids, just like adults, don't eat enough of the fresh fruits, vegetables, and whole grains that are richest in potassium," Swinney says.
How much potassium to get: Here's how much potassium kids need on a daily basis:
Increasing potassium: Besides fruits and vegetables, dairy foods, meats, and seafood are also good potassium sources. In general, the more processed the food, the less potassium it provides, and the more sodium in a food, the lower the potassium.
To help your child get enough potassium, serve at least one fruit or vegetable at every meal and snack and encourage your child to eat a balanced diet.
If you're concerned your kids aren't getting the nutrients they need, talk to their pediatrician. And remember, a diet low in processed foods and rich in produce, whole grains, lean protein, and low-fat dairy can help them -- and you -- get essential nutrients.
SOURCES:Jodie Shield, MEd, RD. Bridget Swinney, MS, RD.National Academies Press: "Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, Fluoride," "Dietary Reference Intakes for Vitamin C, Vitamin C, Selenium and Carotenoids," "Dietary Reference Intakes for Water, Potassium, Sodium, and Chloride."Forshee, R. Journal of the American College of Nutrition, April 2006; vol 25: pp 108-116.U.S. Department of Agriculture: "Dietary Guidelines for Americans 2005."Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010.Pediatric Nutrition Handbook, Fifth Edition, 2004.NIH Office of Dietary Supplements: "Vitamin D: Consumer Fact Sheet."WebMD Health News: "Vitamin D: New Guidelines for Children."
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