Issue 23 / 18 June 2012

CLINICIANS seeing preschool-aged children should routinely enquire about diet, says an expert in paediatric nutrition after Australian research revealed worrying dietary patterns in young children.

Professor Louise Baur, head of weight management services at the Children’s Hospital Westmead, in Sydney, said a good dietary intake was as much a part of a healthy childhood as immunisation, emotional wellbeing and being physically active.

The research, which looked at 3-day weighed-food diaries of 300 children aged 1–5 years, found that many of the preschoolers’ diets lacked fibre and omega-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFA). They also had high intakes of saturated fats.

“Australian children aged 1–5 years are following a dietary pattern that may be associated with adverse long-term cardiovascular health and chronic disease”, the researchers wrote in a paper published this week in the MJA(1)

“Overall, 95% of children aged over 2 had a saturated fat intake that exceeded the maximum recommended limit of 10% of total energy”, they wrote. The study also found that only 18% of children in this age group consumed adequate fibre and 32% received an adequate intake of n-3 LCPUFA.

But it was not all bad news. Preschoolers had an adequate intake of iron, zinc, calcium and vitamin C, the study found.

Professor Baur said asking parents about diet should be a routine part of clinical practice for anyone seeing children.

“GPs, early childhood nurses and paediatricians should enquire about some key elements of dietary intake: Are the family eating together, modelling healthy eating? Is the child having breakfast every day? Is he or she drinking water as the main drink? Are there healthy snacks available?”

She said these few simple questions could give health professionals a sense of whether the family was providing healthful foods to their children.

Professor Baur said she suspected the actual nutritional intake of preschoolers was probably worse than the study indicated.

While she said the weighed-food record was the gold standard in assessing nutrient intake, any form of dietary methodology would tend to elicit socially desirable responses. “So this is, if anything, an underestimate of saturated fat intake and [overestimate] of dietary fibre intake.”

Dr Liz Marles, Royal Australian College of General Practitioners vice-president, said diet was currently a non-mandatory assessment in the Healthy Kids Check.

She said although mandatory height and weight measurements helped to detect obesity, this study suggested that discussions about nutrition with parents of young children should be part of every health check.

However, it was important not to solely focus on the diet of the child. “Kids ultimately end up eating the same sort of food as their parents do”, she said. “So you need to talk to the family about their diet as a whole, rather than just focus on the child.”

Dr Marles said parents might also benefit from guidance about the changing eating patterns in preschoolers.

“For 2–3-year-olds, the rate of growth is slower and their appetite may drop off a bit, and parents often interpret that as them being picky eaters”, she said. “This coincides with tantrums and food becoming an issue, so parents will sometimes try to give their kids anything, as long as they eat. Often that leads to the sorts of foods that are being described here, the dense calories and the high saturated fats and low fruits and vegetables.”

Dr Marles cautioned that this trend was not going to be easy to reverse. “We need to reinforce [health messages], but we have turned into a more sedentary society, we’re more time-poor, we eat more preprepared foods, and they will all contribute.”

– Nicole Mackee

1. MJA 2012; 196: 696-700

Posted 18 June 2012


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