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Pediatrics specialties

Health and wellness

Being healthy means eating properly, taking care of your body by seeing your doctor regularly and taking care of your mind.

From nutritional needs to fat intake, physical activity to tips, this section gives you the basics on your body’s needs — from head to toe.

In the Health and Wellness section you will find information on:

Nutrition

Needs

Childhood-eating patterns can have long-term health effects. Although heart disease typically does not become symptomatic until adulthood, risk factors associated with heart disease may develop during childhood. Dietary intake has a major impact on heart health. Eating large amounts of saturated fat have been associated with increased total cholesterol in childhood, which can ultimately increase the risk of cardiovascular disease.

Young children (under age 5) have the natural ability to adjust meal size according to energy needs. Children can lose this ability if parents assume control over the amount of food the child must eat. If provided with a variety of healthy foods, children should not have difficulty consuming the right amounts of essential vitamins and minerals.

Calories

Caloric needs vary depending on the child’s current growth rate, the amount of physical activity and the child’s metabolism. It is important that children consume enough calories to ensure proper growth and to spare protein from being used for energy. However, many children, especially those who are not physically active, tend to consume too many calories. Children aged 2 to 3 years need approximately 1,300 calories per day; those who are 4 to 6-years-old require around 1,800 calories per day; 7-to 10-year-old children should have roughly 2,000 calories each day.

The American Dietetic Association recommends that children increase their fruit and vegetable consumption to five or more servings daily. Qualitative guidelines put forth in the Dietary Guidelines for Americans, the Food Guide Pyramid and the Food Guide Pyramid for Children are excellent tools.

Sugar

Added sugar is a significant contributor to calorie intake in America, with more than 150 pounds consumed per person per year. Many children drink large amounts of sugary beverages such as sodas and flavored powder drinks. In some cases, the calories consumed in added sugar can meet or exceed the child’s entire daily caloric requirement. This results in excessive weight gain and may mean that other more nutritious foods are not being eaten. It is more beneficial to provide your child with unsweetened beverages like water and milk, and invest the calories in nutritious foods.

Added sugar should not exceed 10 percent of total calories. When choosing packaged foods, look carefully at the ingredient list for sugars with different names like glucose, fructose, lactose, maltose and syrups. When there are many of these sweeteners listed, and when they are toward the top of the ingredient list (ingredients are listed in descending order by weight), the product has a lot of added sugar.

Protein

Protein provides the building blocks for body growth and maintenance. On average, children in the United States consume considerably more protein than is required for health. Protein deficiency is relatively rare in children living in the United States, but may be seen in children with certain medical conditions. As a rule of thumb, protein from a variety of sources (dairy, beans, lean meats) should constitute 12 to 15 percent of total calories.

Fat

Fat is an important nutrient, essential for normal growth and development in children. In the first two year’s of a child’s life, dietary fat plays a key role in the formation of vital nerve and brain tissues. Therefore, dietary fat should not be restricted for children under 2. After age 2, fat continues to play an important role as a source of energy, heat insulation, protection of vital organs and the absorption of fat-soluble vitamins A, D, E and K. Essential fatty acids, which humans cannot synthesize, are components of cell walls and play important roles in supporting the cardiovascular, reproductive, immune and nervous systems. However, dietary fat is another culprit in the excessive number of calories consumed by Americans. So, as children get older, consuming this extra dietary fat can lead to weight gain. By age 5, experts advise that children should follow the adult recommendations to limit total fat intake to 30 percent of calories, saturated fat intake to 10 percent of calories and cholesterol intake to 300 milligrams per day.

Fiber

Children with low fiber intake are at risk for chronic constipation. High-fiber food has five grams or more of fiber per serving, and some experts recommend using the child’s age plus five as a guideline for the grams of fiber that children should consume each day.

Calcium

Because peak bone mass is accumulated in the first two decades of life, adequate calcium intake and exercise are critical for maximizing bone density that will help prevent osteoporosis later in life. Milk is a significant source of calcium, but many children will choose sugared drinks over milk, which reduces the likelihood that they will obtain adequate calcium each day. The recommended calcium intake for school-age children is 1,300 milligrams per day, which can be obtained by having four servings a day of milk or dairy products. Calcium-fortified foods can be beneficial for children who are not consuming enough dairy products.

Physical activity

Childhood is an important time to establish good exercise habits in children. More than one-third of young people in grade nine through 12 do not regularly engage in vigorous-intensity physical activity. Daily participation in high school physical education classes dropped from 42 percent in 1991 to 32 percent in 2001 (Centers for Disease Control, 2002). Inactive children are more likely to become inactive adults, and these children weigh more than active children of the same height. On average, today’s children are slower and weaker than children were years ago, due to the increased hours spent in sedentary activities such as television and video games.

For babies and toddlers, exercise helps develop muscle strength, coordination, balance and reflexes. Regular physical activity is important for the development of healthy bones, muscles and joints, and it builds lean muscle and reduces fat. It also substantially reduces the risk of dying of coronary heart disease, the nation’s leading cause of death, and decreases the risk for stroke, colon cancer, diabetes and high blood pressure. Exercise is known to help reduce feelings of depression and anxiety and may, through its effect on mental health, increase a child’s capacity for learning.

Ensuring that your child gets a minimum of 30 minutes of exercise each day will go a long way to promote good health and instill healthy habits that will carry through his or her lifetime.

Motivation

Healthy eating is about motivation, balance and flexibility. Children, similar to adults, are often motivated by their emotions. One’s desire to eat is controlled by true hunger, appetite and satisfaction.

Some people eat — despite a lack of physical hunger — in order to reduce anxiety or other negative feelings. Often, our emotions get the best of us and we find ourselves eating out of boredom or frustration, or to feel pleasure and get satisfaction from the foods we eat. It is important to look at the factors that lead to eating. When upset, people often turn to food to solve their problems. However, this is just a quick fix, and while food may give a temporary high, feelings soon level off and return to the earlier feeling.

Finding motivation

Maintaining a healthy diet, and even starting one, can take motivation. Encouraging children to eat healthy foods and be physically active can be challenging. It requires patience, practice and time. Be positive. Try to eat only when hungry and teach children to do the same. Eat at the table with family members and enjoy mealtime. Avoid snacking while watching television or doing other activities and have children do the same. Mindless snacking can lead to over consumption of empty calories. Keep healthy snacks available in the car and at home. It can be much easier to eat healthy foods and avoid temptations when they are not within reach.

Place emphasis on essential nutrition for yourself and your children. Rather than reward them with sweets or other goodies, think about children’s needs and come up with creative ways to meet them. Genuine, sincere praise goes a long way toward establishing self-confidence and self-esteem in children.

Tips

Develop healthy habits

During early childhood and school-age years, children start to establish habits for eating and exercise that they may keep for their entire lives. To maintain a healthy lifestyle, parents should act as role models for their children. Parents can participate in sports with their children and encourage them to try a variety of physical activities. Model physical behavior by taking the stairs rather than the elevator and parking in spots far from stores. Incorporate more walking and biking into daily routines. Make family events that involve physical activity a priority for every family member. Finding activities that children and parents enjoy will play an essential role in energizing and keeping kids motivated.

While it is important to let children enjoy various types of entertainment such as television, video games and computer games, parents should set limits and provide encouragement to help children get the daily exercise that they need.

Parents can help children establish healthy eating habits.

  • Allow children to participate in food preparation and make the process fun, not a chore.
  • Control the amount of “junk” food children eat.
  • Make nutritious foods available.
  • Turn off the television during mealtime and eat as a family.

Encourage healthy eating habits

Developing healthy eating habits in a child will last a lifetime. Encourage normal eating, which means eating when hungry and stopping when full. Children do not have to be members of the “clean plate club.” By encouraging normal eating you are encouraging healthy attitudes toward food. Allowing your child some responsibility helps them to grow up knowing how to manage food. Create a relaxed atmosphere at meals. As any parent knows, instilling healthy eating habits in children is challenging and requires patience.

If you are concerned that your child does not eat enough fruits and vegetables, look at your own diet. Do you eat a variety of fruits and vegetables? Remember that you are setting an example for your children.

Create a blueprint for a lifetime of healthy eating.

  • Ask children to help prepare meals and involve them in the meal-planning process.
  • Cut up fruits and vegetables in snack-size portions.
  • Help your child learn which foods are healthy food choices.
  • Include fruits and vegetables in every meal.
  • Involve your children in menu preparation and grocery shopping.
  • Limit high-calorie, high-fat and sugary snacks.
  • Make mealtime a pleasurable event for all involved.
  • Try new foods, savor flavors and swap recipes with friends.

Portion size

One of the key ways to maintain a healthy weight is to control portion sizes. Research has shown that Americans often underestimate how many calories they are consuming each day by as much as 25 percent. “Super-sized” and “value-sized” food items have been on the rise in recent years and are available in grocery stores and restaurants — everywhere you look. Although these larger sized items generally contain two to three servings, it is common for children and adults to eat all portions as if it were one serving.

Ways to control portion size

  • Avoid eating out of a bag or carton.
  • Use smaller dishes at meals.
  • Serve food in the appropriate portion amounts.
  • Store leftovers in separate, portion-controlled amounts.

Home environment

Many children do not eat the required daily amounts of fruits and vegetables. Studies show that in many households adults do not currently eat enough fruits and vegetables either. Parents can experiment with recipes to find new ways to incorporate vegetables and fruits into meals, as well as try a variety of new foods, especially when produce is in season.

To set a good example for children, adults should enjoy eating the foods they want their children to eat. All family members should eat the same foods at meal times, together as a family. Preparing separate foods for family members sends the message that what is good for one person is not good for the other, and can lead to picky eating habits. Everyone at home should be involved in any changes, regardless of body weight, so that no child feels singled out.

Television plays a role in eating habits

While television can entertain and inform children, it also can have a negative effect on them. On average, today’s children spend more time watching television than they spend at school, or doing any other activity besides sleeping.

Children also get information about food from television that may be incorrect or misdirected. Often, they cannot tell the difference between the images presented on television and reality. The countless advertisements for soda, fast foods and “junk” foods influence children.

To ensure your child has a positive experience with television:

  • Place limits on the amount of television children watch.
  • Help children select programs that present realistic characters living healthy lifestyles.
  • Turn off the television during meal times.
  • Watch programs with your children and talk about the characters and food choices they see.