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Q&A about children's nutrition with nutritionist Angela Dowden - ANSWERS BACK

(59 Posts)
RachelMumsnet (MNHQ) Thu 18-Apr-13 11:15:14

We're running a Q&A this week with nutritionist Angela Dowden, who will be available to answer your questions on children's nutrition.

Do you worry about whether you're giving your kids the food that's best for them? Are you concerned about whether they're getting the right vitamins and nutrients from their food to keep them going throughout their day? Should your children snack between meals and if so what sort of snacks should you be giving them? Post your questions to Angela before the end of Tuesday 23 April and we'll post up her answers on Monday 29 April

Angela Dowden is a registered nutritionist and specialises in family nutrition. A freelance journalist, she writes for about health and diet for national newspapers, magazines as well as many national online titles. She is currently working with the makers of Ribena Plus, a range of no added sugar juice drinks with added health benefits.

This Q&A is sponsored by Ribena Plus

Shiraztastic Fri 31-May-13 20:12:55

I love the fact that she has assumed that Madmonkeys dc is not breastfed (no idea if that is the case or not, but it's a pretty big assumption). Ah well, at least she didn't suggest ribena with calcium for that one hmm

AngelaDowden Tue 28-May-13 15:32:38

2012PP

My son is 10 months old & eats pretty much everything (& doesn't have any allergies or intolerances).

When I cook, What should the 'meat/fish - to - carbohydrate' ratio be?

Thanks.

Hi 2012PP, As a general rule, carbs and veg/fruit should make up around two-thirds of a meal with the final third being the meat, fish or other form or protein part. Hope that helps!

AngelaDowden Tue 28-May-13 15:30:05

DuchessOfPodd

What can I build my 6 year old daughter up with? She is as skinny as a beanpole in comparison to her chunkier classmates. Her appetite is huge in the mornings when she will happily devour two big bowls of porridge made with semi skimmed cows or goats milk. Other than that we have a battle getting her to eat much of anything else, just a few mouthfuls of meat and veg for our family evening meal. She does like fruit such as apples, tangerines. Her teachers say she eats well at school. She has just had a sickness bug so is even thinner now than usual.

If she’s growing, thriving, happy and healthy (barring the odd cold or tummy bug, which is to be expected), my qualified advice would be not to worry. You say she eats a very good breakfast and eats well at school. If she eats only a little in the evening, this could simply be because she is intuitively eating according to her needs and this should augur well for the future in terms of her being able to regulate her weight and appetite. Do get her checked out with a medical professional just to make sure everything is okay and that she hasn’t been dropping down the centiles too much though. But provided she checks out fine, I think you may just need to accept that she is naturally thin.

AngelaDowden Tue 28-May-13 15:22:08

pcbmc00

Hi my question is again about overweight children my daughter is 3 eats extremely healthy likes all veg and fruit but she is categorised as overweight using toddler bmi. Now she does have treats by grandparents etc. I'm very careful of portion size but if possible could you guide me on what a toddler should eat daily how many snacks etc/ treats per week is ok? Thanks

Hi Pcbmc00 At the age of three your child should ideally be giving you the lead on how much she needs to eat, whilst you offer a healthy selection of foods in the form of three meals and two snacks a day. For all meals it?s good to begin small and let her ask for more if she needs it. With snacks it need not be much than she can fit in her hand. As far as sweet treats like chocolate or cake are concerned, I think it?s important not to ban these altogether, but to give them only once or twice a week, and in small amounts after a main meal rather than as a between meal snack. Treating good behaviour with food isn?t advised as it can lead to psychological associations that mean she?s more likely to crave sweet foods for comfort or reward later. Ensuring your 3 year old is as physically active as possible will obviously help too. If you?re running out of ideas for snacking I worked with the makers of Ribena Plus on a handy tool called the After School Snack Finder to help in such a situation! You simply put in some details about you kids ? age, gender, if they have done sport and so on ? and it comes up with the ideal after-school snack for them. It?s here at after school snack finder.

AngelaDowden Tue 28-May-13 15:14:15

Shattereddreams

My DD age 6 - How many glasses of milk a day is enough as she is milk free? (oatly milk is calcium enriched to same level as milk) but there is no cheese or yoghurt in diet to top it up. I can work out mg of calcium in each glass of milk so how much is enough? (Cmp intolerant non ig)

My DS age 3 - he isn't a fussy eater, he eats anything if mood takes him, such as olives. But he is tiny and falling down centiles. He is too lazy to eat. He has huge tonsils, could this be a factor?

As a guide the RNI (reference nutrient intake) of calcium for a child is 450mg a day, and the amount you really don’t want to fall below is 275mg, so that should give you some guidelines to work by when you’re working out how many glasses of calcium-fortified milk alternative to give. As a pleasant change you could give her no added sugar Ribena Plus with added calcium and remember there's important sources of calcium found in other foods too, like canned fish, nuts, greens and white bread for example. As far as your other question is concerned, large tonsils in a three year old could potentially be an issue if he cannot eat sufficiently because of pain or because breathing takes constant physical effort. But if this were the case I think he’d be very miserable. As it is, perhaps you could give a little encouragement in term of eating with him, making it easy and interesting with finger food, different textures and flavour etc? Do talk to your GP if he is falling down the centiles though as you need to get to the bottom of why he seems reluctant to eat.

AngelaDowden Tue 28-May-13 15:12:00

MadMonkeys

My 7 month old daughter is dairy intolerant and probably gluten intolerant (we're on an elimination diet to establish that). What should I be including in her diet to replace the calcium etc that she will be missing out on without dairy and gluten?

As your 7 month old is dairy intolerant you’ll need specialist advice on a formula milk to carry on using until she’s 12 months at which point you’ll probably be fine giving calcium fortified soya or rice milks as a drink, but I’d advise you get professional advice, for example from a paediatric dietician, as to exactly what to do and what products to use when. If it turns out she’s gluten intolerant too, you’ll need to avoid wheat, rye and barley, which is usually easiest if you only cook from scratch. Looking at the ingredients list on product labels, which should be clearly displayed on most, gives you a good idea of what ingredients are present, allowing you to more easily identify allergenic ingredients. Fortunately, many early intolerances are grown out of – your daughter is likely to grow out of a milk protein intolerance by school age for example.

PareyMortas Tue 28-May-13 15:10:45

Well that was worth the wait hmm.

AngelaDowden Tue 28-May-13 15:10:08

Morepeasplease

My 8 year old dd was a very fussy eater in the past and whilst she has improved over the years she has become very reluctant to try anything new. She says she doesn't like things knowing full well she has never tasted them, particularly if they have any fruit ingredient. Although she seems healthy enough she eats hardly any veg (maybe a slice of carrot or bit of sweet corn per meal) and no fruit, but does drink smoothies(two varieties only - wont try any others). Eats with rest of family at the table ( all good eaters) and really enjoys helping to cook but just still seems afraid to try new things. Have told her that she can just lick something to taste it, or spit it out if she doesn't like it but she seems certain that she won't like it without trying it.( she is bright enough to understand that she doesn't know what something tastes like without trying it). What can I do to encourage a more positive attitude to new foods? How can I get her to try new things? Or should I just leave her and see if she grows out of it? Don't want to make mealtimes more stressful for her, would love her to relax and just enjoy food. But would love to cook any eat a wider variety of meals, for the sake of my other children as well as myself.

Well I’m not sure if I’m supposed to admit this Morepeasplease, but your 8-year-old daughter sounds exactly like my own son, who at just turned 12 is still adamant he doesn’t like certain things, though this has improved slowly but surely. As there are so may positive things with your daughter – she likes to cook, eats with the rest of the family etc – I’d be inclined not to be too much “on her case” at the moment for fear of this approach backfiring. One thing you could try though is to focus on just one food at a time to introduce to try (spinach for example) and every time it is part of family meals to put a little on her plate, or in a small dish on the side. If she doesn’t even try, don’t make a fuss, but make sure the same food experience gets repeated several times before you move onto another food (it may mean you have to et spinach quite often!). Another trick I found particularly useful was inviting round a friend who had a particularly wide repertoire of foods, if your daughter particularly likes or admires that friend, she may copy their behaviour and try new things.

AngelaDowden Tue 28-May-13 15:07:24

RedundantClare

I am struggling with how to approach the subject weight and over eating with my daughter. She is 12 nearly 13 and clearly " big boned" but I know she is a secret eater and find sweet wrappers in her room and pockets. Our approach to food has always been everything in moderation and nothing is banned. She does moderate exercise but is significantly bigger than her peers and at 5ft tall is wearing size 14 clothes.
What do I say to her without giving her a complex?

For any mum this is always such a difficult one, but it’s good to be thinking about it now, when your daughter still has some growing to do, so you can focus on maintaining her weight (which she will then grow into) rather than actually needing her to begin “dieting”, which is likely to set a yoyo pattern for life. It sounds like you have always had a healthy approach to food, and you mustn’t beat yourself up as acquiring sweets and eating them secretly isn’t that unusual behaviour! You don’t need me to tell you that making her feel completely loved and secure is the key point in any conversation you have with about her weight, and for you to be completely uncritical about her size.

One approach would be to say you’ve decided as a family to go on a health drive and to make her feel part of the family effort. If you do all this taking a health approach rather than a weight one and really practice what you preach you should hopefully nip this in the bud. Key things that might help when you’re preparing family meals is cooking from scratch as much as possible including plenty of lean protein, fruit and veg. Serve a smallish portion on to average sized (not huge) plates and wait for her to ask for some more if she’s still hungry.

Exercise is of course important too for a teenager, both for body and mind – so encouraging the ‘moderate exercise’ that you refer to above is a good idea. If you get stuck for healthy meal or snack options, or are looking ways to increase variety then do take a look at the NHS healthy eating website for inspiration.

AngelaDowden Tue 28-May-13 14:57:18

InMySpareTime

DS (age 11) has a milk allergy, and approaching puberty. How do I get his calcium levels up given he is reluctant to eat green leafy veg and doesn't really like tablets?
Also, he is on epilepsy meds that make him hungry (weight gain not an issue, he's very active and stick thin) any tips on keeping him full so he doesn't keep pestering me for food All. The. Timehmm.

Dairy allergies are not such an issue as they once were, as there are loads of replacement dairy milks like soya, rice, almond etc. All of these can be used on cereals, in hot chocolate etc and are virtually all now fortified with calcium. Nuts and oily canned fish such as tinned mackerel are also a good source, and great for even the fussiest kids is Ribena Plus with added calcium and no added sugar, which will help to top up this important bone mineral. As for keeping him full, I’m afraid I have no guarantees here as he is clearly growing fast!

AngelaDowden Tue 28-May-13 14:55:43

MavisSnapdragon

Fliss, I think Dara O Briain said that dietician vs. nutritionist is a bit like dentist vs. toothiologist!

I'd better come up with a sensible question, now that I've said that! blush

DD1 is tiny for her age, underweight, poor growth (due to past cancer treatment mainly, but probably naturally small as well). She doesn't have a huge appetite, and no sweet tooth at all. DD2 is tall for her age, great appetite, not fussy about food at all, will eat anything, but is rather fond of cakes, biscuits, crisps etc as well as fruit and veg. How do I get extra calories into DD1 without giving DD2 more calories than she needs and without making it seem like DD1 gets all the "good stuff"? I'm really conscious of not making weight/calories etc an issue for either of them as they get older (they are 5 and 7 atm), so I try to give them the same meals and snacks etc (they notice if one has something and the other doesn't!). I think I need some suggestions for high calorie, non-tooth-rotting savory snacks that DD1 will actually eat before DD2 scoffs the lot! She likes crisps and popcorn, but I worry about salt content as she has some damage to her kidneys too.

Ah, now this is a hard one MavisSnapdragon, and I can’t say I envy you! But if you work with the things DD1 does like and DD2 is more ambivalent about, I think that’s probably the key. It’s also okay to give them an “either / or” choice of snack, which gives them a sense of autonomy but is more controlled than giving them the chance to choose! As your older daughter needs to put on weight I have no problem with her eating crisps, but like you mention, salt can be an issue so I’d very much recommend going for the salt free plain varieties, which still taste great. The same goes for popcorn, which can be very salty if bought ready made, but healthy if you pop your own. Some other ideas for high calorie but healthy foods include avocado, peanut butter, hummus and pesto. At meal and snack times always give then the own individual portions rather than putting a bowl in the middle of them and letting D2 eat more than D1! It does seem like perhaps an appointment with a local dietician might be a good option though, as their preferences and needs are so conflicting, to work out the best plan for family meal times.

AngelaDowden Tue 28-May-13 14:52:16

Likeaninjanow

One of my DC has severe food allergies. He is allergic to all dairy, eggs, sesame, peas & pulses, nuts & peanuts. What healthy snacks can I give him to up his calorie intake? The only fruit I can get him to eat is the Ella's kitchen fruit smoothies. He's age 5.

Hi Likeaninjanow, in my opinion you should be referred to a paediatric dietician for specific help with your child?s diet as it?s really tough for you to keep nutritional needs covered when you have to avoid so many foods. I would urge you to progress this via your GP, but in the interim, a couple of snack ideas that spring to mind are home made potato or sweet potato wedges sprinkled with salsa and mashed avocado or mashed banana on top of rice cakes.

AngelaDowden Tue 28-May-13 14:49:13

OhHullitsOnlyMeYoni

My DD is 20mo and has always loved cheese. She would eat it all day if I let her and will sneak it off the side if I turn my back for a second and bite a huge chunk out. It was her first word!
I remember hearing that as adults we should limit ourselves to a matchbox sized amount of cheese - but as children under 5 need more fat, is it alright for her to eat so much cheese? I try to limit it, but how much is alright, or is there no limit, as long as she is eating other nutrients?

That’s some cheese fiend! On the plus side it’s a great source of calcium for her growing bones and also (especially hard cheese) a good source of protein, zinc and vitamins A, B12, B2 (riboflavin) and folate. It does have high amounts of saturated fat though so I’d still suggest limiting it as once she gets beyond a medium sized chunk (40g, or not much more than a matchbox size) she’s well on her way to getting her suggested daily saturated fat limit without leaving much room for the other sources. Toddlers enjoy experimenting with different textures, so have you tried giving a pile of grated cheese as a snack (it goes further than cubes or slices) and perhaps teaming with crunchy raw veg, apples or grapes? Half fat cheddar is an option too, if she accepts it (I wouldn’t normally recommend giving reduced fat foods to toddlers, but half fat cheddar is an exception if kids really like to eat a lot)

AngelaDowden Tue 28-May-13 14:46:31

Shannaratiger

My dd(9) and ds(6) are both really fussy. They are getting better but the only meat dd will eat are chicken and sausages, and ds sausages and value ham. The only fruit and veg ds will eat are bananas, and carrott. Dd eats ready brek which I know has added iron, but i'm still worried how to get more iron into them and how much they should be eating per day.

Hi Cansu, It must have been a real worry when your daughter got measles. I’m not surprised she’s a bit low right now. To help, make sure she has a couple of daily helpings of protein (like chicken, fish, beef, Quorn®, eggs etc), as it’s important and often overlooked in a healthy immune system. Team that with as many varied fruit and veg as you can (I know it’s not always easy, but just do your best!) and you’re giving your daughter’s immune system a good helping hand. However she could probably also do with an age appropriate multivitamin supplement – or if trying to get her to take a supplement is difficult, you could include fortified foods and drinks.

AngelaDowden Tue 28-May-13 14:04:06

Einsty

Frankly? What are your best power-packed easy meals for pre-schoolers. My DD 4 is shockingly reluctant to eat vegetables or anything challenging. I want some basics that will do her good while I work on improving her repertoire.

Hi Einsty, the staples I couldn?t have done without with my kids were pasta with pesto or tomato sauces (worth comparing salt content and choosing the lowest though). Ideally you'd make sure there was some protein in there (so chopped chicken or minced beef), though a handful of grated cheese on top can do the job. Frozen peas or a bit or broccoli or tinned sweetcorn are super quick and easy to add, but if that?s a stretch bear in mind that a tomato pasta sauce counts as a veg portion by itself.

In my experience of fussy kids and watching what kids eat at parties, carrot and cucumber sticks, sliced apples and grapes are probably the most liked and are very easy (carrot sticks are also a great source of vitamin A, which helps to support the immune system). Finally don’t feel guilty about using fish fingers, sausages or oven chips occasionally – they’re fine as part of a balanced diet.

LaraMumsnet (MNHQ) Tue 28-May-13 13:45:22

We finally have the answers back from Angela and I will be posting them up shortly.

RachelMumsnet (MNHQ) Thu 23-May-13 11:08:33

Big apologies for the delay on getting the answers up. We are still waiting and we will chase again today and update you.

DuchessOfPodd Wed 22-May-13 23:46:04

MNHQ?.....are you still waiting for the answers?

RachelMumsnet (MNHQ) Thu 09-May-13 10:09:15

Apologies for the delay in getting the answers back to your questions. They will be with us tomorrow and we'll post them straight up. Thanks.

Shiraztastic Sat 04-May-13 19:39:44

I like Great Ormond Street Hospital's take on what kids should drink more than Ribena's:

"The best drinks to slurp are water and semi-skimmed milk. These don't contain added sugar that can damage teeth. And milk contains important vitamins and minerals, like calcium."

Mind you, they don't have products to sell and give evidence-based advice.

What happened to Ms Dowden?

Shiraztastic Sat 04-May-13 19:28:50
RachelMumsnet (MNHQ) Thu 25-Apr-13 13:03:18

We've spoken to the folks at Ribena Plus who have responded with the following:

"You should drink everything in moderation and the makers of Ribena offer a range of drinks for the whole family, including the new Ribena Plus range with no added sugar and added health benefits.

There are two different types of Ribena Plus:

1) Ribena Plus for Immunity Support, which has added vitamins A, C and E and no added sugar in Blackcurrant, Apple & Peach, new Red Apple or new Summer Fruit (available exclusively in Tesco).  Each serving has 15 per cent of the RDA of vitamin A and E and 100 per cent RDA vitamin C

2) Ribena Plus for Healthy Bones, which has added calcium and no added sugar in Raspberry & Apple.  Each serving has 15 per cent of the RDA of calcium and 100 per cent RDA vitamin C

The makers of Ribena have also signed up as a partner to the government’s Public Health Responsibility Deal to demonstrate their commitment to encouraging people to eat and drink fewer calories".

"In terms of Angela Dowden’s qualifications, she is a registered nutritionist (with the Association for Nutrition http://www.associationfornutrition.org/) with a degree in food science BSc (Hons) who has been published across many news & magazine titles. She was awarded Nutrition & health Writer/Broadcaster of the Year 2012, and is a published author, having written books about nutrition such as Are You Getting Enough?: Vitamins and Minerals for a Long and Healthy Life".

The Q&A is now closed and we've sent up 20 Qs to Angela and will post up her answers on Monday 29th April.

Shiraztastic Tue 23-Apr-13 13:12:08

"We will only host Q&As that we feel will be of use to Mumsnetters and we would not host a Q&A with any individual who we didn't feel was qualified to answer the questions. "

It is this part that causes the issue here. Oh, that and the bit about them not being allowed to plug products 'too heavily', as if somehow a small bit of marketing slipped in is more ethical than an obvious large amount hmm.

I do not think a manufacturer of these sorts of drinks has any part sponsoring a discussion about child nutrition, any more than a junk food manufacturer or a formula company. I just did some searching and discovered that ribena is owned by GSK of all people! They also make lucozade and horlicks. As for their "Ribena plus immunity support" drinks, I don't think I have enough hmm hmm to cover my view of that.

Question: what should kids drink? Answer: water.

Mads86 Mon 22-Apr-13 20:15:21

My doctor advised me to use extra virgin olive oil on my sons' dry skin condition, which I have done, and I have seen a slow but marked improvement over 3 weeks. I have also started to include a teaspoon into his food and he loves it - am I right to be doing this?

NeoMaxiZoomDweebie Mon 22-Apr-13 18:53:49

I have to say that I don't think ANY of Mumsnet's regulars are naive enough to ask a SPONSORED nutritionist for advice regarding their child's diet. grin

it would be great to have a dietitian on though.

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