nutritional guidance for early years: food choices for children aged 1

nutritional guidance for early yearsfood choices for children aged 1-5 years in early education and childcare settings

Scottish Executive, Edinburgh 2006

nutritional guidance for early yearsfood choices for children aged 1-5 years in early education and childcare settings

© Crown copyright 2006

ISBN: 0-7559-4787-8

Scottish ExecutiveSt Andrew’s HouseEdinburghEH1 3DG

Produced for the Scottish Executive by Astron B42854 01/06

Published by the Scottish Executive, January, 2006

Further copies are available fromBlackwell’s Bookshop53 South BridgeEdinburghEH1 1YS

100% of this document is printed on recycled paper and is 100% recyclable

nutritional guidance for early years

Contents

Foreword v

1 Introduction and background 11.1 Why is this guidance needed? 21.2 What is this guidance for? 21.3 Who is this guidance for? 21.4 Links with other resources 31.5 Putting policy into context 3

2 Eating habits, nutrients, foods and menu planning 52.1 Developing good eating habits 62.2 Foods and nutrients 72.3 Menu planning and nutrient guidance 82.4 Example menus 27

3 Additional information 333.1 Oral and dental health for pre-school children 343.2 Snacks 343.3 Drinks 363.4 Physical activity 363.5 Vegetarian and vegan diets 373.6 Food choices and religious faiths and beliefs 373.7 Children with special needs or therapeutic diets 373.8 Vitamin supplementation 38

4 Putting nutritional guidance into practice 394.1 Working in partnership 404.2 Working alongside parents and guardians 414.3 Developing a food and nutrition policy 424.4 Staff development and training 444.5 Monitoring and evaluation 444.6 Areas for further consideration 44

Appendices 45Appendix 1 Nutrient guidance for children aged 1 to 5 years 46Appendix 2 Menu planning 49Appendix 3 Menus 2 and 3 with weighted portion sizes 51Appendix 4 Children’s fruit and vegetable portion sizes 57Appendix 5 Food for religious faiths and beliefs 58Appendix 6 Putting it into practice 59Appendix 7 Sample food and nutrition policy 60Appendix 8 Working group 61Appendix 9 References and resources 62

iii

iv

“Scotland has a poor record on children’s oral health and the Scottish Executive and the dentalprofession are working hard to tackle the problem. But dental services cannot tackle theproblem alone. A healthy diet and learning good food and oral hygiene habits will play a keypart in improving our children’s oral health. Early education and childcare settings have animportant role to play in this. I therefore support this guidance and the contribution it willmake to promoting our children’s oral health.”

Ray Watkins, Chief Dental Officer, Scottish Executive

“City of Edinburgh Council Children and Families Department believes firmly in the importanceof diet and nutrition for the future health and wellbeing our youngest children. We will be workingwith colleagues in a range of agencies to incorporate the use of these guidelines into thedelivery of our Health Strategy for children.”

Roy Jobson, Director, Children and Families Department, City of Edinburgh Council

“Scottish Childminding Association welcomes the publication of the Nutritional Guidance forEarly Years as a tool to enhance registered childminders understanding of the need to provideappropriate healthy meals to children in their care. This resource complements Adventures inFoodland, introduced to our membership last year. Registered childminders have an importantrole to play in encouraging and introducing healthy choices within their childcare setting. Thekey task will be accessing training opportunities for childminders to allow them to turn thisguidance into practice.”

Elizabeth Murdoch, Head of Childminding Practice Development, SCMA

“The Care Commission fully supports the Scottish Executive’s healthy eating initiative. We intendto help encourage healthy eating through our inspection programme for next year. We will askchildcare providers and childminders whether they have the guidance and how they are usingit. We will encourage service providers to improve practice by using the guidelines. We willreport on what we find.”

Ronnie Hill, Director of Children’s Services Regulation, Care Commission



Foreword

The Scottish Executive is committed to ensuring that every child in Scotland has the best possible start in life. Making sure that our youngest children have healthy,nutritious diets is an important part of that commitment. We know that many earlyyears settings already work hard to provide healthy food to the children in their care.This guidance will help them do that.

Improving the country’s diet is a key part of making people in Scotland healthier.Encouraging young children to eat healthily not only helps their growth anddevelopment as children, it also establishes good eating habits for life. We want to help young children to enjoy a healthy diet, and nurseries, childminders and other childcare providers have a major role to play in this.

We would like to thank all the colleagues, from a range of professional backgrounds,who provided their views and advice in the consultation process. In particular wewish to thank the Working Group for all their expertise, hard work and enthusiasm.

Robert Brown Lewis Macdonald

v

vi


1 Introduction and background

1

2

1.1 Why is this guidance needed?

Good nutrition in the early years is vital. Children’s early experiences of food play an important partin shaping later eating habits, and good eating habits support healthy growth and development.Giving positive messages about food in the early years setting will also help to stress the importanceof a good diet to children’s families.

As someone working in early education, you will recognise the importance of giving children anutritionally balanced diet – and that you are in a position to make a difference. This guidance hasbeen produced to support you in meeting children’s nutritional needs in the early years. It is evidencebased (meaning that it is practical advice based on nutritional research) and sets out the nutritionalrequirements for children aged 1 to 5, providing practical advice on how to ensure that theserequirements are met.

Throughout, references to other useful publications and resources are indicated by a numbered notemarker (e.g. Fun First Foods3). These resources are listed in full in Appendix 9.

1.2 What is this guidance for?

It will help you to work towards the quality of service described in the National Care Standards –Early Education and Childcare up to the Age of 16; Standard 3 Health and Wellbeing:1

National Care Standard 3 – Each child or young person will be nurtured by staff who will promotehis or her general wellbeing, health, nutrition and safety.

It is especially relevant to National Care Standards 3.3 and 3.4:

National Care Standard 3.3 – Children and young people have opportunities to learn about healthylifestyles and relationships, hygiene, diet and personal safety.

National Care Standard 3.4 – Children and young people have access to a well-balanced and healthydiet (where food is provided) – which takes account of ethnic, cultural and dietary requirements,including food allergies.

1.3 Who is this guidance for?

The guidance is for providers of childcare for children aged 1 to 5 years who provide food (includingsnacks) and/or drinks. It will apply to a wide range of providers, including local authority nurseries,private nurseries, playgroups, childminders, toddler groups, crèches, school meal services andfamily centres, regardless of the length of time that children are being cared for.

We do not address the needs of children from birth to 1 year here. Nutrition in the first 12 months ofa child’s life is crucially important and is covered in detail in Off to a Good Start,2 Fun First Foods3

and Adventures in Foodland,4 all available from NHS Health Scotland.

Parents and other carers need to know about this guidance and what they can expect their child toreceive in terms of food and drink.



1.4 Links with other resources

The information in this guidance reflects that in Adventures in Foodland,4 which is very comprehensiveand provides background information on nutrition, dental health and physical activity for carers ofchildren under 5, as well as a series of ideas for practical activities with food. This guidancecomplements Adventures in Foodland4 by making the links between practical food choices andachieving the specific nutrition guidance for children.

At a local level, there are many resources designed to improve nutrition in the early years, some ofwhich will be useful in helping to put the guidelines into practice. To find out about these, contactyour local authority’s early years department.

1.5 Putting policy into context

Improving children’s health is the collective responsibility of parents, guardians, early years staff andcarers, and health professionals.5

It is also an important priority for the Scottish Executive and this is where you can help. The strategyImproving Health in Scotland – the Challenge6 identifies the early years as one of the four key areasfor health improvement, as well as putting special focus on diet and physical activity as a way ofachieving this. Eating for Health: Meeting the Challenge,7 another strategy paper, recommends thatwe need nutritional guidance for the pre-school sector if we are to improve children’s health.

Other important documents in this area are the Curriculum Framework for Children 3 to 58 andNational Care Standards – Early Education and Childcare up to the Age of 16.1 This guidance aimsto help you work towards these standards. Increasing the rate of improvement in the health of peopleliving in the most deprived areas of Scotland is a key objective of the Scottish Executive’s approachto tackling poverty and disadvantage (see Closing the Opportunity Gap9). Improving diet andnutrition will benefit everyone in Scotland but the most disadvantaged groups, including childrenliving in poor families, will benefit the most.

3

4


2 Eating habits, nutrients, foodsand menu planning

5

6

A varied and nutritious diet and regular physical activity are very important to ensurehealthy growth and development in young children.10,11,12 In the short term, they not onlyimprove growth but also improve concentration and support children’s learning.10,13

There are longer term health benefits as well, as poor eating habits in childhood canlead to the development of obesity14 and anaemia as a result of iron deficiency.13,15

Even more importantly, a good diet in childhood can help to prevent the risk of seriousdiseases common in later in life,15,16 such as cancer, cardiovascular disease, diabetesand osteoporosis.

2.1 Developing good eating habits

National Care Standard 3.31 requires that children and young people have the opportunity to learnabout healthy lifestyles, including a healthy diet. This covers a number of points:

• Encourage children to experiment: offering a variety of foods and repeatedly introducing new foodsfrom an early age encourages children to experiment and accept different tastes and textures.17

• Plan snack and meal times: we already know that young children need to have structure to theirday and this applies to planning times for eating and drinking. Children differ in their responses tofood being made available: most children enjoy food and usually welcome an opportunity to takea snack or drink when they are hungry or thirsty. However some children are less interested, maybe distracted while playing and can ‘forget’ or be ‘too busy’ to choose to eat or drink. This canresult in children becoming ‘over’ hungry or thirsty, leading to difficult behaviour. Therefore, it isimportant to organise snack time so that every child has a chance to eat and drink. Snack timeprovides an excellent opportunity for children to: practise personal hygiene by washing theirhands before eating/drinking; learn about healthy snacks and drinks; and learn to try new foodsand chat to staff about their likes and dislikes. Children are more likely to try new foods if theysee other children eating them. For all these reasons, a timetabled snack time, supervised by staffto ensure that every child’s needs are met, is regarded as current best practice.

• Allow plenty of time: give children enough time to finish eating and drinking – once they havestarted to eat, this may take around 15 minutes for a snack and 30 minutes for a meal. Childrenneed to eat regularly and it is recommended that they be offered something to eat at least every 3 hours. Snacks are best given well before or after meal times to avoid spoiling the appetite forthe next meal.

• Develop social skills: when children sit down together to eat and drink this provides an excellentopportunity for them to learn good social skills and behaviours associated with eating and drinking.For example: chatting to other children and adults, developing good table manners, offering andsharing food, learning to respect others, tasting and trying foods from different cultures. Try toavoid distractions such as television and lots of noise.

• Provide good role models: children often model their behaviour on others. Therefore, encouraginggood food choices and eating habits in the adults, brothers and sisters, and friends around childrenis important in reinforcing the right messages.

Further information and activities for building positive eating habits is provided in Adventures inFoodland.4



2.2 Foods and nutrients

Energy needs: getting the balance right

Children need energy to enable them to grow and develop and be active. Essentially, energy fromfood and drink provides ‘fuel’ for the body. Energy comes from foods containing carbohydrate, fatand protein. The precise amount of energy required for an individual child depends on their age, size,gender, rate of growth and level of activity.

For good health and optimal growth, it is important to get the balance right between energy consumedin food and energy expenditure.14 Children who are regularly active (see section 3.4) are able toachieve a better energy balance than children who are less physically active.14

Dietary fibre

Dietary fibre as part of a varied, balanced diet is essential for good health at all ages. Althoughthere are no specific dietary recommendations for children aged 1 to 5 years, children who followthe ‘five-a-day’ guidance on fruit and vegetable intake and who have some wholegrain foods, e.g.wholegrain bread, cereals and pulses (e.g. peas, beans, lentils), incorporated into their daily dietswill have an adequate intake of dietary fibre to maintain good health as they grow.

7

CASE STUDY

Snacking Together at Ladywell Nursery School Ladywell Nursery School used to run an ‘open snack’ system, however staff were concerned that somechildren were not keen to have a snack while others were limited in the foods they would try. Issuesaround hygiene, e.g. children washing their hands properly and the use of utensils to serve food, werealso raised. It was decided that, for a trial period, snack time would be a group activity with an earlyyears worker sitting with each group of children. Snack items were set on a tray which was taken tothe group table where the children helped to prepare and serve the snack. This new way ofapproaching snack time was so successful that it has now been adopted as permanent practice andstaff have highlighted a range of benefits:

• Development of social skills through interaction and co-operation with others, e.g. taking turns.

• Development of language skills as children and adults talk together about what they are eating,foods they like to eat and health issues including toothbrushing and handwashing.

• Children are more easily encouraged to try new foods and can see what the whole food looks likebefore helping an adult to prepare and serve it.

• Staff are more aware of what children are eating and can share this information with parents.

• Children can make suggestions for foods to be included in the snack menu.

• Staff can observe children closely, gathering information for their profiles in several areas ofdevelopment.

Overall, snack time is now less stressful for the children and both children and adults enjoy it!

8

Vitamins, minerals and bioactive components

These are essential for growth, development and normal body functions. Some vitamins and mineralsare important for the immune system to protect against ill health and disease. Children aged 1 to 5have a high requirement for vitamins and minerals because of the rapid rate of growth and bonedevelopment during these years. An adequate intake of vitamins and minerals will be provided by a varied well-balanced diet, as described in the guidance. Vitamin D is the one exception to this:obtaining adequate vitamin D depends on getting enough sunlight and/or taking supplements (see Appendix 2).

There are some compounds in foods (bioactive components) that do not fall into the categories ofvitamins and minerals or nutrients, e.g. lycopene and flavonoids. Some of these compounds help toprotect against ill health and disease. Vegetables, some fruits and other plant foods such as freshherbs are particularly good sources of these.

Further guidance on the role of nutrients and key sources of nutrients are provided in Adventures inFoodland.4

2.3 Menu planning and nutrient guidance

Menu planning

Menu planning is very important in achieving a well-balanced and healthy diet for the children in yourcare. It will also help you to work towards providing the quality of service described in National CareStandard 3.4.1

Menu planning should be done by a member of staff with the knowledge and skills and anunderstanding of children’s differing nutritional needs. The menu planning guidance set out below should be used to help produce a written menu covering all food provided, i.e. meals,snacks and drinks.

Young children have changing likes and dislikes and their appetite and willingness to try new foodsvaries. Different foods and portion sizes may need to be interchanged as breakfast, snacks, lightmeals or main meals. This need for flexibility to allow for changing eating habits has been takeninto account in the guidance on food groups and menu planning. Children’s cultural backgroundshould also be acknowledged and any special dietary requirements included in planning meals andsnacks, as reflected in National Care Standards – Early Education and Childcare up to the Age of16; Health and Wellbeing Standard 3.4.1

In planning a menu it is important to include a variety of sensory qualities, e.g. taste, texture, flavours,colours and temperature. This will help children’s learning and enjoyment of food. Early and repeatedexposure to a food also helps children to accept it and learn to like it in the long term.17

In the food groups and sample menus that follow, descriptions of foods and the frequency of servingare given only as a guide towards meeting the nutritional guidance. A flexible approach, building oncatering experience, skills and local tastes, will allow a wide range of food and menu options to beused. The menu planning guidance is based on the five food groups (see Adventures in Foodland4

for further information).



It is important to ensure that all food is stored and prepared safely. For the most up-to-date informationon food safety and hygiene for the early years see the Food Standards Agency’s Eatwell website(www.eatwell.gov.uk).18 It is packed with reliable and practical advice about healthy eating,understanding food labels and how what we eat can affect our health.

The Food Standards Agency has also developed specifications for the quality of processed foods tobe used in school meals,19 which may be useful for foods used in catering for the early years sector.

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ldd

ishe

s,in

soup

san

dco

mb

ined

with

vege

tab

les.

Ther

eis

none

edto

add

salt

whe

nco

okin

gfo

ods

from

this

grou

p.

Pro

cess

edp

asta

and

rice

pro

duc

ts(e

.g.

nood

les

ina

pot

,sa

vour

yric

ein

ab

agan

dtin

ned

spag

hett

ihoo

ps

insa

uce)

tend

toha

vea

very

high

salt

cont

ent.

Man

ufac

ture

rsar

ew

orki

ngto

pro

duc

elo

wer

salt

vers

ions

,so

ifca

nned

spag

hett

iand

sim

ilar

pro

duc

ts(e

.g.

spag

hett

ihoo

ps,

pas

tash

apes

)are

used

,ch

oose

the

red

uced

salt

varie

ties.

Why

?

Thes

efo

ods

are

ago

odso

urce

ofca

rboh

ydra

teen

ergy

and

Bvi

tam

ins.

They

pro

vid

ea

varie

tyof

text

ures

and

tast

esfo

ryo

ung

child

ren.

Who

legr

ain

varie

ties

ofric

ean

dp

asta

are

high

erin

Bvi

tam

ins

than

the

whi

teva

rietie

s.

Thes

ep

roce

ssed

pro

duc

tsar

em

ostly

very

high

insa

ltan

dif

eate

nre

gula

rlyth

eyw

illco

ntrib

ute

toa

high

-sal

td

iet.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


13

Gro

up2:

Fru

itsan

dVe

get

able

s

Fre

sh,f

roze

n,ca

nned

and

dri

edva

riet

ies

of

frui

tsan

dve

get

able

san

dfr

uit

juic

es

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Eve

rym

eals

houl

dco

ntai

na

min

imum

of

bet

wee

no

nean

dtw

och

ild-s

ized

po

rtio

nsfr

om

this

gro

up(s

eeA

pp

end

ix4)

.

The

snac

kan

dm

ealc

omb

inat

ions

shou

ldp

rovi

de

ava

riet

yo

fve

get

able

san

dfr

uits

.Chi

ldre

nm

ayp

refe

rra

wve

get

able

s(e

.g.c

ucum

ber

,to

mat

o,

carr

ots

,cel

ery)

.

The

ym

ayfin

dth

emea

sier

toea

tif

serv

edcu

tup

into

smal

lpo

rtio

ns(e

.g.c

hop

ped

app

lean

dsa

tsum

ase

gm

ents

).O

ffer

ing

them

rep

eate

dly

may

imp

rove

acce

pta

nce.

Off

erin

gfr

uit

and

raw

veg

etab

les

(e.g

.cho

pp

edap

ple

,cho

pp

edcu

cum

ber

)at

the

beg

inni

ngo

fth

em

eal,

or

asa

snac

k,m

ayhe

lpto

imp

rove

upta

ke.

Tin

ned

frui

tsh

oul

db

ein

frui

tju

ice

or

natu

ral

juic

ean

dno

tin

syru

p.

Cho

ose

tinne

dve

get

able

sin

wat

erw

ithno

add

edsa

lt.

Why

?

Fru

it,ve

get

able

san

dsa

lad

sar

eri

chso

urce

so

fvi

tam

ins,

min

eral

san

do

ther

bio

activ

eco

mp

one

nts,

whi

chp

rote

ctch

ildre

nfr

om

illhe

alth

.Thi

sp

rote

ctio

nb

egin

sea

rly

and

cont

inue

sth

roug

hout

life.

The

yal

sop

rovi

de

anex

celle

ntco

mb

inat

ion

of

fluid

and

fibre

tohe

lpp

reve

ntco

nstip

atio

nin

youn

gch

ildre

n.

Off

erin

gth

ese

colo

urfu

lfo

od

sw

itha

vari

ety

of

tast

esan

dte

xtur

esst

imul

ates

child

ren’

sin

tere

stin

frui

tsan

dve

get

able

sas

wel

las

chal

leng

ing

thei

rp

alat

es.

The

intr

od

uctio

no

fa

vari

ety

of

frui

tan

dve

get

able

sat

ayo

ung

age

may

imp

rove

cons

ump

tion

thro

ugho

utlif

e.T

his

will

help

tom

eet

the

reco

mm

end

atio

nof

five

por

tions

ad

ay.

Off

erin

gra

wch

op

ped

frui

tsan

dve

get

able

sat

the

beg

inni

ngo

fa

mea

lwhe

nch

ildre

nar

em

ost

hung

ryan

d‘w

aitin

g’f

or

thei

rfo

od

isan

exce

llent

way

tog

etth

emto

eat

mo

refo

od

sfr

om

this

gro

up.

Tin

ned

frui

tin

syru

pha

sa

hig

had

ded

sug

ara

cont

ent,

whi

chco

ntri

but

esto

too

thd

ecay

.

Man

ytin

ned

veg

etab

les

are

inb

rine

,whi

chis

salte

dw

ater

.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

14


Gro

up2:

Fru

itsan

dVe

get

able

s

Vege

tab

les

(gre

enan

dsa

lad

vege

tab

les,

root

vege

tab

les,

pul

ses)

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Ser

veve

geta

ble

sso

that

they

are

app

ealin

gan

dus

er-f

riend

ly.

They

may

be

pop

ular

cold

,ra

w,

asfin

ger

food

s,se

rved

with

frui

tin

sala

dor

inco

rpor

ated

into

mai

nd

ishe

s.

Fres

hso

ups

with

vege

tab

les

are

anex

celle

ntw

ayof

incl

udin

gp

ulse

san

dve

geta

ble

sin

am

eal.

Ther

esh

ould

be

am

inim

umof

one

por

tion

ofve

geta

ble

sin

each

serv

ing

ofso

up.

Mos

td

ried

and

tinne

dso

ups

are

very

high

insa

ltan

dso

me

have

alo

wve

geta

ble

cont

ent.

Avo

idth

ese

food

sas

they

mak

eit

diff

icul

tto

mee

tth

enu

trie

ntgu

idan

cefo

rso

diu

m(s

alt).

Bak

edb

eans

are

nutr

itiou

san

dp

opul

arw

ithch

ildre

n;w

hen

serv

ing

them

,ch

oose

low

ersa

ltve

rsio

ns.

Can

ned

spag

hett

iand

sim

ilar

pro

duc

ts,

e.g.

spag

hett

ihoo

ps,

pas

tash

apes

and

tom

ato

ketc

hup

,ar

eno

tve

geta

ble

san

dth

eref

ore

do

not

coun

tas

ap

ortio

n.

Why

?

Vege

tab

les

are

esse

ntia

lfor

ab

alan

ced

die

t.Th

eyco

ntai

nun

ique

pro

tect

ive

com

pon

ents

that

are

not

foun

del

sew

here

inth

ed

iet.

Be

crea

tive

toen

cour

age

youn

gch

ildre

nto

cons

ume

them

ona

dai

lyb

asis

.S

ome

child

ren

pre

fer

vege

tab

les

raw

asfin

ger

food

orin

corp

orat

edin

tod

ishe

sra

wra

ther

than

serv

edin

the

trad

ition

alw

ay.

Itis

not

unco

mm

onfo

rca

nned

spag

hett

ior

pas

tash

apes

insa

uce

tob

em

ista

ken

for

ase

rvin

gof

vege

tab

les.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


15

Gro

up2:

Fru

itsan

dVe

get

able

s

Frui

t

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Frui

tsh

ould

be

offe

red

with

ever

ym

eala

ndm

ost

snac

ks.

Frui

t-b

ased

des

sert

s,su

chas

fres

hfr

uit,

tinne

dfr

uit

inju

ice,

frui

tsa

lad

s,fr

uit

crum

ble

,fr

uit

jelly

orfr

uit

pie

,ar

ep

opul

arop

tions

for

youn

gch

ildre

n.Th

ese

com

pos

itefr

uit

dis

hes

shou

ldco

ntai

na

min

imum

ofon

ep

ortio

nof

frui

tp

erse

rvin

g.

Mos

tfr

uit

yogh

urts

pro

vid

ele

ssth

anon

ep

ortio

nof

frui

tan

dth

eref

ore

fres

hfr

uit

shou

ldb

eof

fere

din

add

ition

tofr

uit

yogh

urt.

Pur

efr

uit

juic

eis

ago

odso

urce

ofvi

tam

inC

.A

smal

lgla

ssor

cup

ofp

ure

unsw

eete

ned

frui

tju

ice,

take

nas

par

tof

am

eal,

pro

vid

esen

ough

vita

min

Cfo

rth

ed

ay.

Frui

tju

ice

shou

ldb

egi

ven

only

atm

ealt

imes

.

Drie

dfr

uit

isan

exce

llent

sour

ceof

nutr

ient

sb

utb

ecau

seof

itshi

ghsu

gar

cont

ent

shou

ldb

egi

ven

atm

ealt

imes

only

.

Why

?

Ther

ear

em

any

frui

t-fla

vour

edsw

eet

pro

duc

tson

the

mar

ket,

man

yof

whi

chco

ntai

nlit

tleor

nofr

uit

but

are

sim

ply

flavo

ured

tore

sem

ble

frui

t.M

ake

sure

that

frui

td

esse

rts

have

ahi

ghp

rop

ortio

nof

real

frui

tso

that

they

cont

ribut

eto

over

alld

aily

frui

tin

take

.

Frui

tju

ice

ishi

ghin

add

edsu

gars

aan

dac

idic

,an

dd

rinki

ngju

ice

alon

e(i.

e.no

tas

par

tof

am

eal)

cont

ribut

esto

toot

hd

ecay

.Fr

uit

juic

ean

dot

her

drin

kssh

ould

alw

ays

be

serv

edin

acu

por

glas

s(w

ithor

with

out

ast

raw

)rat

her

than

from

ab

ottle

.

Drie

dfr

uit

has

ahi

ghnu

triti

onal

valu

ean

dis

ago

odfo

odfo

rch

ildre

nto

lear

nto

enjo

y.H

owev

er,

asit

stic

ksto

teet

han

dca

nca

use

den

tald

ecay

,it

shou

ldb

ep

rovi

ded

atm

eal

times

only

.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

16


Gro

up3:

Milk

and

Dai

ryF

oo

ds

Milk

and

dai

ryfo

od

s,yo

ghu

rts

and

milk

-bas

edd

esse

rts

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

All

mea

land

snac

kco

mb

inat

ions

sho

uld

cont

ain

ap

ort

ion

or

po

rtio

nso

ffo

od

fro

mth

isg

roup

.

Why

?

Inch

ildre

nag

ed1-

3th

ere

isra

pid

dev

elo

pm

ent

of

the

teet

han

db

one

sas

they

gro

wan

dm

ove

aro

und

mo

rein

dep

end

ently

.Cal

cium

,vita

min

D,p

hosp

horu

s,p

rote

inan

do

ther

min

eral

sar

ees

sent

ialf

or

this

stag

eo

fd

evel

op

men

tan

dar

ep

artic

ular

lyw

ella

bso

rbed

fro

mm

ilkan

dm

ilkp

rod

ucts

.

Milk

and

milk

pro

duc

tsp

rovi

de

ari

chso

urce

of

som

eo

fth

ese

nutr

ient

s.D

iets

that

do

not

incl

ude

any

milk

and

dai

ryfo

od

sar

eun

likel

yto

mee

tth

eca

lciu

mre

qui

rem

ents

for

youn

gch

ildre

n.If

ach

ildd

oes

not

have

thes

efo

od

s(e

.g.i

sve

gan

),p

aren

ts/g

uard

ians

sho

uld

seek

advi

cefr

om

ahe

alth

pro

fess

iona

lto

mak

esu

reth

atth

ere

isad

equa

teca

lciu

min

the

die

t.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


17

Gro

up3:

Milk

and

Dai

ryF

oo

ds

Milk

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Pla

indr

inki

ngm

ilksh

ould

beav

aila

ble

asan

optio

nev

ery

day.

Som

ech

ildre

nm

ayst

illbe

havi

ngbr

east

milk

atan

dbe

yond

the

age

of1

year

.For

1ye

arol

ds,w

hoar

eno

tbei

ngbr

east

fed,

who

leco

ws

milk

shou

ldbe

the

mai

nm

ilkdr

ink

until

the

child

isat

leas

t2ye

ars

old.

From

age

2,se

mi-s

kim

med

milk

can

bein

trod

uced

aslo

ngas

the

child

isea

ting

wel

lan

dge

ttin

gen

ough

ener

gyan

dnu

trie

nts

from

ava

ried

diet

.Ful

lysk

imm

edm

ilkis

nots

uita

ble

asa

mai

nm

ilkdr

ink

for

child

ren

unde

r5

year

s.Fr

om5

year

sol

dfu

llysk

imm

edm

ilkca

nbe

used

.

Whe

reon

lyon

ety

peof

milk

isav

aila

ble

(e.g

.in

the

nurs

ery

sett

ing)

,who

lem

ilksh

ould

bepr

ovid

ed.

Drin

king

milk

shou

ldbe

anac

com

pani

men

tto

mea

lsan

dsn

acks

and

not

are

plac

emen

tfo

rth

em.

Pla

inm

ilksh

ould

be

pro

vid

ed.F

lavo

ured

milk

sar

eun

suita

ble

bec

ause

ofth

eir

high

suga

rco

nten

t.

Why

?

Milk

prov

ides

esse

ntia

lnut

rient

san

dflu

idin

are

adily

avai

labl

efo

rm.W

hole

milk

isal

soan

impo

rtan

tsou

rce

ofen

ergy

fory

oung

child

ren.

Low

-fat

skim

med

milk

cont

ains

insu

ffici

ente

nerg

yan

dfa

t-so

lubl

evi

tam

ins

forc

hild

ren

aged

1-5

year

s.

Occ

asio

nally

ach

ildw

illge

tint

oth

eha

bito

fdr

inki

ngla

rge

amou

nts

ofm

ilk(m

ore

than

500m

lpe

rda

y)in

stea

dof

eatin

got

her

food

s.Th

ism

ayha

ppen

afte

ra

perio

dof

illne

sssi

mpl

ybe

caus

eth

ech

ildre

fuse

sto

eats

olid

food

.You

ngch

ildre

nw

hope

rsis

tent

lydr

ink

larg

eam

ount

sof

milk

rath

erth

anea

ting

will

have

adi

etth

atis

defic

ient

inen

ergy

and

othe

rnu

trie

nts,

e.g.

iron

and

Bvi

tam

ins.

Flav

oure

dm

ilks

are

high

inad

ded

suga

rsan

dca

nca

use

toot

hd

ecay

.Th

eyar

eal

sove

rysw

eet

and

enco

urag

ea

‘sw

eet

toot

h’.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

18


Gro

up3:

Milk

and

Dai

ryF

oo

ds

Yogh

urt

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Yogh

urti

sve

rypo

pula

rw

ithch

ildre

nan

dth

ere

isa

huge

varie

tyof

frui

t-ba

sed

and

frui

t-fla

vour

edyo

ghur

tsto

choo

sefro

m.

Who

le-m

ilk/p

lain

natu

raly

oghu

rt/p

lain

from

age

frai

sdo

esno

thav

ead

ded

suga

ra .Th

ese

are

idea

lop

tions

and

can

bese

rved

with

fresh

,ste

wed

orfro

zen

frui

t,or

frui

tin

natu

ralj

uice

s.

Atm

ealt

imes

,cho

ose

who

le-m

ilkfr

uity

oghu

rt/f

ruit

from

age

frai

sth

atis

low

inad

ded

suga

ra .

Nov

elty

yogh

urts

,e.g

.car

toon

-typ

e,co

rner

-typ

eyo

ghur

tsw

ithbi

ts,m

ouss

esan

dyo

ghur

tsin

atu

bear

em

ostly

very

high

inad

ded

suga

rsa .

Som

eco

ntai

ncr

umbl

yan

dst

icky

subs

tanc

es(e

.g.

choc

olat

e,fu

dge)

,whi

chst

ick

toth

ete

eth

and

caus

eto

oth

deca

y.Th

ese

shou

ldno

tbe

prov

ided

.

Oth

erde

sser

ttyp

efo

ods

for

child

ren

inca

rton

slik

eyo

ghur

tmay

bem

ore

like

swee

tsor

choc

olat

ean

dco

ntai

nlit

tlem

ilkor

frui

t.Th

ese

shou

ldno

tbe

prov

ided

.

Why

?

Yogh

urts

can

bean

exce

llent

sour

ceof

calc

ium

,pr

otei

n,vi

tam

inA

and

smal

lam

ount

sof

vita

min

D(w

hole

-milk

varie

ty)a

ndth

eyar

eea

syto

eat.

Ther

eis

ahu

gech

oice

ofyo

ghur

tson

the

mar

ket

and

itis

ofte

ndi

fficu

ltto

know

whi

chgi

ves

the

best

nutr

ition

alva

lue.

Som

ear

ele

sshe

alth

yth

anot

hers

:av

oid

thos

ew

ithst

icky

suga

red

bits

like

swee

ts.

Pla

inyo

ghur

tand

plai

nfro

mag

efra

isis

the

best

optio

nan

dca

nbe

take

nas

part

ofa

snac

kor

mea

l.

Frui

t-fla

vour

edyo

ghur

tsco

ntai

ning

low

amou

nts

ofad

ded

suga

rsa

are

less

harm

fult

ote

eth20

than

yogh

urts

high

insu

gars

and

thos

ew

ithst

icky

swee

tbi

ts.

The

swee

tene

dst

icky

addi

tions

tom

any

nove

ltyyo

ghur

tsar

eha

rmfu

lto

child

ren’

ste

eth

and

can

cont

ribut

eto

exce

ssen

ergy

inta

kefro

msu

gar.

Yogh

urts

houl

dbe

eate

nus

ing

asp

oon

and

swee

tene

dyo

ghur

tsho

uld

notb

esu

cked

from

atu

beas

this

isha

rmfu

lto

child

ren’

ste

eth.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


19

Gro

up3:

Milk

and

Dai

ryF

oo

ds

Che

ese

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Che

ese

can

bese

rved

asth

em

ain

prot

ein

item

inst

ead

ofm

eat,

fish

orpu

lses

.

Che

ese

can

bese

rved

asch

eese

and

bisc

uits

,ch

eese

and

frui

t,as

part

ofa

sala

dor

asa

fillin

gfo

rsa

ndw

iche

san

dba

ked

pota

toes

,or

sprin

kled

onto

pof

past

aor

rice

dish

es.A

suita

ble

smal

lpor

tion

ofha

rdch

eese

for

ayo

ung

child

isar

ound

20-2

5g.

Cot

tage

chee

sem

akes

ani

cech

ange

from

hard

chee

sean

dca

nbe

serv

edin

ala

rger

port

ion

of40

-50g

.

Che

eses

suita

ble

for

vege

taria

nch

ildre

nsh

ould

beav

aila

ble.

Why

?

Che

ese

isa

conc

entr

ated

sour

ceof

calc

ium

and

othe

rmin

eral

s.Th

epr

otei

nan

dm

iner

alco

nten

tm

ayal

sohe

lpto

prom

ote

dent

alhe

alth

.

Whe

rea

port

ion

ofch

eese

isse

rved

asth

em

ain

prot

ein

item

,ita

lso

coun

tsas

apo

rtio

nof

food

from

the

mea

t,fis

han

dal

tern

ativ

eso

urce

sof

prot

ein

food

grou

p.

Mos

thar

dch

eese

san

dfu

ll-fa

tsof

tche

eses

,tho

ugh

good

food

s,ar

ehi

ghin

satu

rate

dfa

t,so

stic

kto

the

port

ions

reco

mm

ende

dto

avoi

dex

cess

inta

ke.

Vege

taria

nch

ildre

nw

illno

ttak

ech

eese

that

cont

ains

renn

etas

itis

anan

imal

-bas

edin

gred

ient

.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

20


Gro

up4:

Mea

t,F

ish,

Eg

gs,

Pul

ses,

See

ds

and

Nut

s

Mea

t,fis

han

dal

tern

ativ

es,

e.g

.eg

gs,

pea

s,b

eans

,len

tils

and

nuts

Bee

f,p

ork,

lam

ban

dp

oultr

y

Pro

cess

edm

eat

pro

duc

tsan

dp

ies

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Eve

rym

ain

mea

lsho

uld

cont

ain

ap

ort

ion

or

po

rtio

nso

ffo

od

fro

mth

isg

roup

.

Red

mea

t(b

eef,

por

kan

dla

mb

)-b

ased

mea

lssh

ould

be

serv

eda

min

imum

oftw

ice

aw

eek.

Lean

mea

t(fa

ttr

imm

edof

f)sh

ould

be

used

inco

mp

osite

dis

hes.

Pro

cess

edm

eat

pro

duc

ts,

i.e.

hot

dog

s,fr

ankf

urte

rs,

saus

ages

,p

roce

ssed

bee

fb

urge

rs,

and

mea

tbal

ls,

hagg

isan

dsh

aped

pou

ltry

pro

duc

ts(e

.g.

nugg

ets)

,p

astr

y-to

pp

edp

ies

and

othe

rp

astr

yp

rod

ucts

(e.g

.b

ridie

s,sa

usag

ero

lls,

Cor

nish

pas

ties,

Sco

tch

pie

s)sh

ould

be

serv

eda

max

imum

ofon

cea

wee

k.

The

vege

tabl

eco

nten

tof

com

posi

tedi

shes

such

asho

mem

ade

pies

shou

ldbe

incr

ease

dw

here

poss

ible

.Pot

ato-

topp

edpi

essh

ould

been

cour

aged

inpr

efer

ence

topa

stry

-top

ped

pies

beca

use

ofth

eir

low

erfa

tco

nten

t.D

ono

tad

dsa

lt.

Why

?

Mea

t,fis

han

dal

tern

ativ

essu

chas

egg

s,b

eans

and

pul

ses

are

am

ajo

rso

urce

of

pro

tein

,iro

nan

dzi

nc.T

hese

help

top

rom

ote

gro

wth

inch

ildre

n.M

ost

child

ren

livin

gin

the

UK

have

mo

reth

anad

equa

team

oun

tso

fp

rote

inin

thei

rd

iet.

Red

mea

tis

the

bes

tso

urce

ofiro

nan

da

maj

orso

urce

ofzi

nc.

Lean

mea

tsar

ehi

gher

inp

rote

in,

iron

and

zinc

than

mea

tsw

itha

high

fat

cont

ent.

This

will

help

toim

pro

veth

enu

triti

onal

qua

lity

ofm

eat

used

inre

cip

essu

chas

spag

hett

ib

olog

nese

,ca

sser

oles

and

stew

s.

Pro

cess

edm

eat

pro

duc

tsar

em

ostly

high

infa

tsan

dsa

lt.Th

eq

ualit

yof

fat

may

be

unhe

alth

y(h

igh

insa

tura

ted

and

hyd

roge

nate

dfa

ts)a

ndth

eq

ualit

yof

pro

tein

poo

rer

than

infr

esh

orfr

ozen

lean

erm

eats

.A

lso

they

may

be

low

erin

iron

and

zinc

than

lean

mea

ts.

Usi

ngp

otat

oin

ap

iep

rovi

des

ener

gyan

dva

ries

the

text

ure

ofa

com

pos

ited

ish

whi

leal

soad

din

gm

ore

nutr

ient

s,e.

g.vi

tam

ins

and

min

eral

s.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


21

Gro

up4:

Mea

t,F

ish,

Eg

gs,

Pul

ses,

See

ds

and

Nut

s

Com

pos

ited

ishe

s

Fish

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Thes

ed

ishe

s,e.

g.la

sagn

e,m

ouss

aka,

spag

hett

ib

olog

nese

,tu

nap

asta

bak

e,ra

viol

i,et

c.,

shou

ldco

ntai

nle

anm

eats

,sm

alla

mou

nts

ofch

eese

and

ple

nty

ofve

geta

ble

s.A

lway

sin

crea

seth

eve

geta

ble

cont

ent

whe

neve

rp

ossi

ble

and

do

not

add

salt.

Whe

nfa

tis

used

inco

okin

gor

ind

ishe

s,us

ea

vege

tab

leoi

lhig

hin

mon

ouns

atur

ated

orp

olyu

nsat

urat

edfa

t,e.

g.ol

ive

oil,

rap

esee

doi

l,su

nflo

wer

oilo

rsa

fflow

eroi

l.

Fres

hor

froz

enun

pro

cess

edfis

h,in

add

ition

totin

ned

tuna

,sh

ould

be

onth

em

enu

atle

ast

once

ina

full

5-d

aym

enu.

Oil-

rich

fish:

sard

ines

,ki

pp

ers,

salm

on,

mac

kere

l,fr

esh

tuna

and

herr

ing

(exc

lud

ing

tinne

dtu

na)

shou

ldb

ese

rved

atle

ast

once

ina

full

5-d

aym

enu.

Pro

cess

edfis

hp

rod

ucts

,e.

g.fis

hfin

gers

and

shap

edfis

hp

rod

ucts

,m

ayb

ehi

ghin

salt

and

shou

ldb

ese

rved

nom

ore

than

once

ina

full

5d

aym

enu.

Why

?

Vege

tab

les

can

be

easi

lyin

corp

orat

edin

toth

ese

dis

hes

orco

ldsa

lad

item

s(c

ucum

ber

,to

mat

o,le

ttuc

e,ce

lery

and

carr

ot)c

anb

ese

rved

alon

gsid

eas

finge

rfo

ods.

This

will

help

toin

crea

seth

eve

geta

ble

inta

ke.

Vege

tab

leoi

lshi

ghin

mon

ouns

atur

ated

and

pol

yuns

atur

ated

fats

imp

rove

the

typ

eof

fat

inth

ed

iet.

This

will

pro

vid

eva

riety

.Ti

nned

tuna

fish

islo

wer

inp

rote

ctiv

efa

tty

acid

sth

anot

her

typ

esof

oily

fish.

This

doe

sno

tap

ply

tofr

esh

tuna

.21,2

2

Oil-

rich

fish

cont

ain

valu

able

,p

rote

ctiv

efa

tty

acid

sth

atar

ed

efic

ient

inth

eS

cott

ish

die

tso

we

need

toin

crea

seth

eir

inta

ke.

Oil-

rich

fish

are

also

one

ofth

efe

wna

tura

llyric

hso

urce

sof

vita

min

D.

Man

ych

ildre

nar

eno

tfa

mili

arw

ithth

ese

food

san

dsh

ould

be

enco

urag

edto

try

them

by

intr

oduc

ing

tast

ers

(e.g

.sa

rdin

eson

toas

t).

Man

yof

thes

ep

rod

ucts

are

high

insa

lt,al

thou

ghm

anuf

actu

rers

are

star

ting

top

rod

uce

varie

ties

with

alo

wer

salt

cont

ent.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

22


Gro

up4:

Mea

t,F

ish,

Eg

gs,

Pul

ses,

See

ds

and

Nut

s

Cho

pp

ednu

ts,

nut

pas

tes

and

nut/

seed

pas

tes

Vege

taria

nso

urce

sof

pro

tein

(see

sect

ion

3.5

for

mor

ed

etai

lsab

out

vege

taria

ns)

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Nut

ssh

ould

not

be

give

nw

hole

toch

ildre

nag

ed1

to5

year

sas

ther

eis

aris

kof

chok

ing.

Cho

pp

ednu

tsan

dnu

tp

aste

sca

nb

eof

fere

d.

Pro

tein

sour

ces

for

vege

taria

nsin

clud

e:p

ulse

s,se

eds,

chop

ped

nuts

,se

ed/n

utp

aste

s,eg

gs,

chee

se,

yogh

urt,

tofu

and

soya

min

ce.

Thes

esh

ould

be

varie

dth

roug

hth

ew

eek.

Soy

am

ince

,te

xtur

edve

geta

ble

pro

tein

(TV

P),

quo

rnan

dto

fuca

nb

esu

bst

itute

dfo

rm

ince

and

chic

ken

inm

ain

com

pos

ited

ishe

s,e.

g.sp

aghe

tti

bol

ogne

se,

cass

erol

es,

stir-

frie

s.

Pro

cess

edve

geta

rian

pro

duc

tsre

sem

blin

gm

eat

pro

duc

ts,

e.g.

saus

ages

and

vegg

ieb

urge

rssh

ould

be

serv

edno

mor

eth

anon

cea

wee

k.

Why

?

Cho

pp

ednu

tsm

ayb

eus

edin

reci

pes

.

Thes

ear

ea

good

sour

ceof

ener

gy,

pro

tein

and

min

eral

s.

You

will

need

tob

eca

refu

lwith

child

ren

who

may

have

anu

tal

lerg

y(s

eese

ctio

n3.

7).

Thes

esh

ould

be

the

mai

nso

urce

sof

pro

tein

for

vege

taria

ns.

The

pro

tein

cont

ent

ofve

geta

rian

dis

hes

isof

ten

low

erth

anin

mea

td

ishe

s.H

owev

er,

vege

taria

nsca

nge

tsu

ffici

ent

pro

tein

from

thes

ed

ishe

sal

ong

with

the

othe

rso

urce

sof

pro

tein

inth

eir

die

ts,

e.g.

cere

alp

rote

in,

milk

pro

duc

ts.

Pul

ses,

incl

udin

gb

eans

,le

ntils

and

pea

sp

rovi

de

exce

llent

nutr

ition

,in

clud

ing

pro

tein

.Th

eyar

eve

ryve

rsat

ilefo

ods

for

qui

cklig

htm

eals

and

asin

gred

ient

sin

soup

san

dca

sser

oles

.P

ulse

sca

nb

ean

alte

rnat

ive

toa

por

tion

ofm

eat,

fish,

eggs

orch

eese

.Th

isin

crea

ses

the

varie

tyfo

rve

geta

rians

.

Man

ym

eat

sub

stitu

tes

are

sim

ilar

inte

xtur

eto

mea

tan

dm

ayno

tap

pea

lto

child

ren

who

do

not

like

mea

t.A

lso,

som

em

ayb

ehi

ghin

salt.

Pro

cess

edve

geta

rian

pro

duc

tsar

em

ostly

high

infa

tsan

dsa

lt.Th

eq

ualit

yof

fat

inso

me

ofth

emis

unhe

alth

y(h

ydro

gena

ted

fats

).

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


23

Gro

up5:

Fo

od

sH

igh

inF

atan

dF

oo

ds

and

Dri

nks

Hig

hin

Ad

ded

Sug

arsa

Thi

sg

roup

incl

udes

but

ter

and

spre

ads,

coo

king

fats

and

oils

,d

esse

rts,

conf

ectio

nery

,co

ldan

dho

td

rink

s,sa

vour

ysn

acks

and

bo

ttle

dsa

uces

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

With

inth

isg

roup

ther

ear

ece

rtai

nfo

od

sth

atm

ake

anim

po

rtan

tco

ntri

but

ion

toth

ed

iet

of

child

ren,

e.g

.but

ter,

spre

ads,

coo

king

oils

,fru

itan

dm

ilkd

esse

rts.

Als

ow

ithin

this

gro

upar

efo

od

sth

atar

ehi

gh

inad

ded

sug

arsa

or

po

or

qua

lity

fats

and

/or

salt,

e.g.

soft

drin

ks,s

wee

ts,c

hoco

late

conf

ectio

nery

,ch

oco

late

and

crea

m-f

illed

bis

cuits

,sug

ary

pas

trie

s,su

gar

yd

esse

rts,

hig

hly

swee

tene

dce

real

s,su

gar

yst

icky

yog

hurt

s,co

rnsn

acks

and

cris

ps.

The

sesn

ack-

typ

efo

od

sar

eo

ften

unhe

alth

yan

dun

nece

ssar

y.

Bo

ttle

dsa

uces

are

gen

eral

lyve

ryhi

gh

insa

ltan

dsh

oul

dno

tb

een

cour

aged

asp

art

of

the

mea

l.

Why

?

But

ter,

spre

ads

and

oils

cont

rib

ute

toth

eta

ste,

text

ure

and

enjo

ymen

to

fth

ed

iet.

The

yar

eim

po

rtan

tas

conc

entr

ated

sour

ces

of

ener

gy

for

youn

gch

ildre

nw

hoar

eg

row

ing

rap

idly

.F

ruit

and

milk

des

sert

so

ffer

go

od

sour

ces

of

vita

min

san

dm

iner

als

and

are

ap

leas

ant

chan

ge

fro

msa

vour

yfo

od

s.

The

sefo

od

sar

eea

ten

too

oft

enb

ym

any

child

ren,

esp

ecia

llyif

they

have

freq

uent

and

easy

acce

ssto

them

.Thi

sco

ntri

but

esto

ap

oo

r-q

ualit

yd

iet,

whi

chca

nre

sult

ino

bes

ity,

po

or

gro

wth

,to

oth

dec

ayan

dg

ener

alp

oo

rhe

alth

.The

ove

rco

nsum

ptio

no

fsn

ack

foo

ds

hig

hin

add

edsu

gar

a ,fa

tsan

dsa

ltis

reco

gni

sed

aso

neo

fth

em

ajo

rp

rob

lem

sw

eha

vein

Sco

tland

.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

24


Gro

up5:

Fo

od

sH

igh

inF

atan

dF

oo

ds

and

Dri

nks

Hig

hin

Ad

ded

Sug

arsa

Des

sert

s:p

udd

ings

,ca

kes,

bis

cuits

,ja

m,

jelly

and

ice

crea

m

But

ter

and

spre

ads

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

All

des

sert

sof

fere

dsh

ould

be

frui

t-an

d/o

rm

ilk-

bas

ed(in

clud

ing

yogh

urt

and

ice

crea

m).

Enc

oura

geca

tere

rsto

revi

ewho

me-

bak

ing

reci

pes

tore

duc

efa

tsan

dad

ded

suga

rsa

and

incl

ude

nutr

ient

-ric

h,w

hole

food

ingr

edie

nts,

e.g.

drie

dfru

it/fre

shfru

its.H

ome-

baki

ng/b

aker

ypr

oduc

tsca

nb

eof

fere

din

min

i-p

ortio

ns(e

.g.

25-3

5g)a

san

acco

mp

anim

ent

tofr

uit

asa

des

sert

.

Onl

yb

utte

ror

spre

ads

rich

inm

onou

nsat

urat

edan

dp

olyu

nsat

urat

edfa

tsan

doi

lssh

ould

be

used

,e.

g.ol

ive,

rap

esee

d,

sunf

low

eror

saffl

ower

oil.

Thes

eca

nb

esp

read

onb

read

san

dus

edin

bak

ing.

Coo

king

mar

garin

esan

dlo

wfa

tsp

read

sof

less

than

40%

fat

are

not

reco

mm

end

ed.

Why

?

Des

sert

san

dp

udd

ings

are

pop

ular

and

are

imp

orta

ntfo

rb

oost

ing

the

tota

lene

rgy

inch

ildre

n’s

die

tsb

utth

eysh

ould

also

pro

vid

enu

trie

nts.

They

can

also

help

toin

crea

sefr

uit

and

milk

inta

ke.

Ther

ear

ea

wid

era

nge

ofth

ese

pro

duc

tsm

arke

ted

atch

ildre

nan

dw

ene

edto

be

care

ful

tose

lect

thos

ew

itha

high

milk

and

/or

frui

tco

nten

tan

dlo

wad

ded

suga

rsa .

The

por

tion

size

ofho

me

bak

ing/

bak

ery

pro

duc

tsis

too

big

for

youn

gch

ildre

n,e.

g.la

rge

muf

fins.

Min

i-p

ortio

nsi

zes

are

muc

hb

ette

ran

dse

rved

alon

gw

ithfr

uit

will

imp

rove

the

bal

ance

ofth

ed

iet.

Chi

ldre

nen

joy

the

diff

eren

tta

stes

and

text

ure

this

pro

vid

es.

Thes

ep

rovi

de

anim

por

tant

sour

ceof

ener

gy,

esse

ntia

lfat

san

dfa

t-so

lub

levi

tam

ins

for

child

ren.

They

help

toac

hiev

ea

heal

thy

fat

pro

file

inth

ed

iet.

Coo

king

mar

garin

esar

ehi

ghin

hyd

roge

nate

dfa

ts.

Youn

gch

ildre

nre

lyon

fat

asa

maj

oren

ergy

sour

ce,

low

fat

spre

ads

are

low

inen

ergy

.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up


25

Gro

up5:

Fo

od

sH

igh

inF

atan

dF

oo

ds

and

Dri

nks

Hig

hin

Ad

ded

Sug

arsa

Coo

king

fats

and

oils

Sw

eete

ned

soft

(stil

land

fizzy

)d

rinks

,sw

eets

,co

nfec

tione

ry,

choc

olat

e,ic

e-p

oles

,su

gary

pas

trie

s,ch

ocol

ate

bis

cuits

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Onl

yth

ose

rich

inm

onou

nsat

urat

edan

dp

olyu

nsat

urat

edoi

lssh

ould

be

used

e.g.

oliv

e,ra

pes

eed

orsu

nflo

wer

oil.

Sw

eete

ned

soft

(stil

land

fizzy

)drin

ks,

swee

ts,

conf

ectio

nery

,ch

ocol

ate,

ice-

pol

es,

suga

ryp

astr

ies,

choc

olat

ean

dcr

eam

-fill

edb

iscu

itssh

ould

not

be

pro

vid

edas

par

tof

the

men

u.

Sug

ary

and

/or

fizzy

drin

kssh

ould

not

feat

ure

asp

art

ofp

re-s

choo

lchi

ldre

n’s

die

tas

they

are

asso

ciat

edw

ithto

oth

dec

ayan

dca

nco

ntrib

ute

top

oor

nutr

ition

alhe

alth

and

exce

ssiv

ew

eigh

tga

in(s

eese

ctio

n3.

3).

Milk

and

pla

inw

ater

are

suita

ble

drin

ksfo

rth

roug

hout

the

day

and

for

bet

wee

nm

eals

.

Fres

hun

swee

tene

dfr

uit

juic

esh

ould

be

offe

red

only

atm

ealt

imes

.Ju

ice

shou

ldb

ed

runk

from

acu

por

glas

san

dno

tfr

oma

bot

tle.

Why

?

They

pro

vid

ean

imp

orta

ntso

urce

ofen

ergy

and

esse

ntia

lfat

sfo

rch

ildre

n.Th

eyhe

lpto

achi

eve

ahe

alth

yfa

tp

rofil

ein

the

die

t.

Thes

efo

ods

are

ener

gy-d

ense

bec

ause

ofth

eir

high

add

edsu

gara

and

/or

high

fat

cont

ent.

Man

yof

them

are

ofp

oor

nutr

ition

alq

ualit

y,p

rovi

din

glit

tlevi

tam

ins

orm

iner

als.

Are

gula

rhi

ghin

take

ofth

ese

food

sby

youn

gch

ildre

nw

illre

plac

efo

ods

ofhi

gher

nutr

ition

alqu

ality

and

resu

ltin

anim

bala

nce

inth

eto

tald

iet.

This

can

resu

ltin

obes

ity,i

ron

defic

ienc

yan

dpo

orgr

owth

.As

thes

efo

ods

are

curr

ently

cons

umed

inla

rge

amou

nts

byS

cott

ish

child

ren,

we

need

topa

ypa

rtic

ular

atte

ntio

nto

guid

ing

child

ren

and

fam

ilies

tore

duce

over

cons

umpt

ion.

Milk

prov

ides

anim

port

ant

sour

ceof

nutr

ition

for

youn

gch

ildre

n.W

ater

prov

ides

esse

ntia

lflu

idan

d,al

ong

with

fibre

,hel

psto

prev

ent

cons

tipat

ion.

Fres

hfr

uit

juic

esh

ould

be

dis

tingu

ishe

dfr

om‘fr

uit

drin

ks’.

Frui

td

rinks

ofte

nco

ntai

nve

rylit

tleor

nofr

uit

juic

eat

alla

ndar

eof

ten

high

inad

ded

suga

rsa

and

acid

s.Fr

uit

juic

esar

eno

tsu

itab

lefo

rd

rinki

ngb

etw

een

mea

lsb

ecau

seof

thei

rhi

ghsu

gar

and

acid

cont

ent.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

26


Gro

up5:

Fo

od

sH

igh

inF

atan

dF

oo

ds

and

Dri

nks

Hig

hin

Ad

ded

Sug

arsa

Sav

oury

pot

ato

snac

ks,

cris

ps

and

corn

snac

ks

Tab

lesa

lt,b

ottle

dsa

uces

,re

lishe

san

dp

ickl

es

Gui

dan

cefo

rC

hild

ren

aged

1-5

year

s

Cris

ps

can

be

offe

red

asp

art

ofa

snac

kor

mea

lop

tion

asan

alte

rnat

ive

text

ure

and

tast

e,e.

g.b

esid

ea

fille

dsa

ndw

ich

orsa

lad

dis

h.H

owev

er,

they

shou

ldno

tb

ep

rovi

ded

asth

em

ain

stap

leof

the

mea

land

shou

ldno

tb

ein

clud

edm

ore

than

twic

eon

afu

ll5-

day

men

u.Fo

ryo

ung

child

ren,

this

wou

ldb

ea

smal

lpor

tion

(e.g

.10-

15g)

.

Do

not

add

salt

tofo

odd

urin

gco

okin

gor

atth

eta

ble

.

Bot

tled

sauc

es(e

.g.

ketc

hup

)are

pop

ular

with

child

ren

and

may

be

high

insa

ltan

dsu

gar.

They

can

be

give

noc

casi

onal

lyin

very

smal

lpor

tions

only

atm

ealt

imes

(e.g

.5g

).

Why

?

Thes

ear

ep

opul

arw

ithch

ildre

nan

dca

np

rovi

de

ach

ange

ofte

xtur

ean

dta

ste.

They

shou

ldno

tb

ere

gard

edas

rep

laci

ngon

eof

the

mai

nst

aple

food

s(i.

e.b

read

s,p

otat

oes,

rice,

pas

taor

cere

als)

.Th

eyar

ehi

ghin

salt

and

soth

ep

ortio

nsi

zean

dfr

eque

ncy

with

whi

chth

ese

food

sar

eof

fere

dsh

ould

be

limite

d.

Thes

efo

ods

cont

ribut

eto

exce

ssso

diu

m(s

alt)

inta

kein

youn

gch

ildre

n.E

atin

gth

emon

are

gula

rb

asis

inla

rge

amou

nts

can

cont

ribut

eto

ahi

gh-s

alt

die

t.

Me

nu

Pla

nn

ing

by

Fo

od

Gro

up

aA

dd

edsu

gars

:th

ese

are

som

etim

eskn

own

asno

n-m

ilkex

trin

sic

suga

rs(N

ME

S)o

rfr

eesu

gars

and

are

foun

din

swee

ts,

bis

cuits

,so

ftd

rinks

,b

reak

fast

cere

als,

tab

lesu

gar,

hone

y,an

dfr

uit

juic

e.Th

eyar

eno

tfo

und

inp

lain

milk

orin

food

ssu

chas

frui

tan

dve

geta

ble

s.


27

Nutrient guidance

The information in Appendix 1 provides guidance on providing adequate energy and nutrition forchildren aged 1 to 3 years and 3 to 5 years attending partial day care or pre-school education. Thenutrient guidance is based on UK Dietary Reference Values,23 which is an average reference valuefor groups of children and does not apply to individual children. As individuals, children have differentenergy and nutrient requirements depending on their age, gender, body size, rate of growth andlevel of activity.

For young children, there are no hard and fast rules about what must be served as a breakfast, asnack, a light meal or a main meal. Depending on likes and dislikes, their appetite and theirwillingness to try foods, food items can be interchanged for snacks, meals or breakfast. For thisreason, nutrient guidance has been given for one meal, including drinks (Appendix 1, Table 1) andalso for the combination of one meal and one snack (Appendix 1, Table 2). Some children receiveonly a snack and drink while in nursery, so suitable snacks and drinks for children aged 1 to 5 arelisted in sections 3.2 and 3.3.

The nutrient figures in Table 1, Appendix 1, represent the recommended nutrient intake provided byone meal averaged over 5 days. A period of 5 days is used because nutrient requirements aregenerally met over a period of time, rather than within one day. This would apply, for example, tothe meals (e.g. lunch) provided to children aged 1 to 5 years who are in early years care.

Table 2, Appendix 1, represents the recommended nutrient intake provided by one meal and onesnack averaged over 5 days. This would apply, for example, to a combined meal and snack (e.g.morning snack and lunch) provided for children who are in early years care.

There are some key issues about nutrient provision to consider when menu planning. These aredetailed in Appendix 2.

2.4 Example menus

The following menu has been designed to meet the nutrient guidance for 1 to 5 year olds averagedover a normal 5-day care-provision period. Each day’s menu identifies all meals, snacks and drinksoffered throughout the day (with the exception of plain water, which is assumed to be offered tochildren regularly throughout the day, including at meal times).

There are difficulties with achieving the dietary reference value for sodium (salt) for all children andfor vitamin D for children aged 1 to 3 (Appendix 2). Two sets have been provided to demonstratepotential planning over a 10-day period. The following menus are examples only and are expressedin practical household measures. These are as follows: teaspoon (tsp = 5ml), dessertspoon (dsp =10ml), tablespoon (tbs = 15ml) and a mug measures 300ml to the brim.

More accurate weights for each food item may be required and for this the example menus withweights of foods have been included in Appendix 3. The weighted menus are given for 1 to 3 yearsand 3 to 5 years separately to illustrate the food requirements for the different age groups.

Staff who are responsible for planning menus need to be supported by proper training and this isdiscussed further in section 4.4. They should also be encouraged to be creative in adapting menusto provide for children with special needs, therapeutic diets, religious requirements (Appendix 5) orvegetarian diets. Some alternatives for vegetarian choices have been provided as examples.

Some points to note when reading the example menus to follow are:

• Drinks• Only milk and plain still water are offered between meals. • Pure, unsweetened orange juice is provided only at meal times. • Where only one type of milk is available, whole milk will be used.• Water is provided in addition to, rather than as a replacement for, the milk included in the menus.

• Dried fruit is provided only at meal times.

• The spread used is monounsaturated or polyunsaturated.

• Sauces used in composite dishes, e.g. spaghetti bolognese, macaroni cheese, and soups aremade from fresh ingredients and are not processed, ready-made varieties which are high in salt.

To check the quality of your planned menus, a menu checklist is included in Appendix 6.

28



29

Day 1 2

Bre

akfa

st

2tb

sp

ure,

unsw

eete

ned

oran

geju

ice

dilu

ted

with

wat

era

por

ridge

(1 /3-

1 /2

mug

)ser

ved

with

milk

1sm

alls

lice

toas

ted

who

lem

ealb

read

with

spre

add

and

jam

2tb

sp

ure,

unsw

eete

ned

oran

geju

ice

dilu

ted

with

wat

era

1-2

bis

cuits

ofW

eeta

bix

serv

edw

ithm

ilk

1sm

alls

lice

toas

ted

who

lem

ealb

read

with

spre

adan

dja

m

Mid

-mo

rnin

gsn

ack

1sm

allg

lass

ofm

ilk

1m

ini/m

ediu

mS

cotc

hp

anca

kew

ithsp

read

1ta

nger

ine

1sm

allg

lass

ofm

ilk

finge

rfo

ods

sele

ctio

nin

clud

ing:

2-4

bre

adst

icks

2-3

chee

secu

bes

(1-1

1 /2

tbs

grat

ed)

app

lech

unks

(1 /2

med

ium

app

le)

Lunc

h

spag

hett

ibol

ogne

seb

(ap

pro

x1 /

2m

ugsp

aghe

tti

and

1 /2

mug

sauc

e)w

ithad

ded

chop

ped

carr

ot(1

bab

yca

rrot

)

3-5

tbs

cust

ard

and

apric

ots

(2-5

stew

edd

ried

apric

ots)

1m

ini/s

mal

lwho

lem

ealp

itta

bre

adfil

led

with

1or

2th

insl

ices

ofro

ast

chic

ken,

b1

tbs

ofsw

eetc

orn,

2sl

iced

cher

ryto

mat

oes,

dic

edcu

cum

ber

(1cm

pie

ce)

milk

jelly

(2-4

tbs)

with

2tb

sch

opp

edp

inea

pp

le

Mid

-aft

erno

on

snac

k

1sm

allg

lass

ofm

ilk

finge

rfo

odse

lect

ion

incl

udin

g:1 /

2sm

allb

anan

a,fr

esh

app

lesl

ices

(1 /2

med

ium

app

le),

serv

edw

ith1-

2he

aped

tbs

ofp

lain

yogh

urt

asa

dip

1sm

allg

lass

ofm

ilk

min

ifru

itsc

one

with

spre

ad

1p

lum

Tea

grat

edch

edd

arch

eese

,(1

-3tb

s)an

dto

mat

osl

ices

,(3

or4)

–sa

ndw

iche

db

etw

een

2sl

ices

ofto

aste

dw

hite

bre

adw

ithsp

read

man

dar

inor

ange

segm

ents

inju

ice

(1-2

tbs)

with

1sc

oop

ofva

nilla

ice

crea

m

smal

lbow

lof

vege

tab

leso

up–

(1 /2-

3 /4

mug

serv

edw

ith1

med

ium

/thi

cksl

ice

ofcr

usty

whi

teb

read

(with

spre

ad)

3-5

tbs

cust

ard

and

pea

ches

(2-3

slic

es)

32

tbs

pur

e,un

swee

tene

dor

ange

juic

ed

ilute

dw

ithw

ater

a

1sl

iced

hard

-boi

led

eggc

serv

edw

itha

smal

lslic

eof

toas

ted

who

lem

ealb

read

with

spre

ad

1sm

allg

lass

ofm

ilk

1to

aste

dte

acak

ew

ithsp

read

1-11 /

2la

rge

por

kan

db

eef

saus

ageb

(gril

led

)ser

ved

with

asm

allb

aked

pot

ato

and

2tb

sb

aked

bea

ns2-

3d

ried

apric

ots

1 /2-

1tb

sra

isin

s

1sm

allg

lass

ofm

ilk

1 /2

smal

lban

ana

slic

ed

1d

spp

lain

from

age

frai

s

chic

ken

risot

tob

(1 /2-

1m

ug)

with

1-2

larg

esl

iced

mus

hroo

ms

app

lecr

umb

le(2

-3he

aped

tbs)

serv

edw

ithm

ilk

42

tbs

pur

e,un

swee

tene

dor

ange

juic

ed

ilute

dw

ithw

ater

a

3-5

tbs

corn

flake

sw

ithm

ilkan

d1

dsp

rais

ins

1sm

alls

lice

ofto

aste

dw

hite

bre

adw

ithsp

read

1sm

allg

lass

ofm

ilk

1sm

allb

anan

aor

finge

rfo

odse

lect

ion,

e.g.

1 /2

ban

ana

and

4gr

apes

1sl

iced

hard

-boi

led

eggc

with

who

lem

ealb

read

sold

iers

(1-1

1 /2

slic

eb

read

),w

ithsp

read

rice

pud

din

g(1 /

3-1 /

2m

ug)

with

1 /2-

1d

spsu

ltana

s

1sm

allg

lass

ofm

ilk

1m

ini(

or1 /

2la

rge)

muf

finto

aste

dw

ithsp

read

1sm

alls

lice

ofm

elon

min

ced

bee

fin

grav

yb

(1 /3-

1 /2m

ug)s

erve

dw

ith2-

3tb

sm

ashe

dp

otat

oes

and

asp

ear

ofb

rocc

oli

frui

tco

ckta

ilin

juic

e(1 /

3

mug

)

Me

nu

1:

A1

0-d

ay

me

nu

for

ch

ild

ren

ag

ed

1to

5ye

ars

wit

hsu

gg

est

ed

po

rtio

ns

inh

ou

seh

old

me

asu

res

30


Day 5

Bre

akfa

st

2tb

sp

ure,

unsw

eete

ned

oran

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31

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32


3 Additional information

33

34

3.1 Oral and dental health for pre-school children

As a carer, you can work with young children and parents to help develop good oral and dentalhealth habits.

Key messages for pre-school children to improve dental health include:

Toothbrushing

• Toothbrushing should begin as soon as the first teeth erupt. • Children should brush their teeth twice a day using toothpaste containing 1,000 ppm fluoride.

No more than a smear of fluoride toothpaste should be used for children under 2 years and asmall pea-sized quantity for children 2 to 6 years.

• Children will need supervision with toothbrushing until they are 6 to 8 years old.

Registering with a dentist

• Children should be registered with a dentist no later than 6 months or as soon as the first tootherupts. If parents have not registered their child with a dentist by the time they come to your care,ask them to do so.

• Children should have regular check-ups with a dentist.

Diet

• Choose foods low in added sugars. Foods containing any added sugars should be eaten only atmeal times.

• Water and plain milk should be the only type of drink given between meals. • Drinks should be given from a cup or glass, with or without a straw, and not from a bottle.

For further information on the prevention of tooth decay in pre-school children see An Action Planfor Improving Oral Health and Modernising NHS Dental Services in Scotland.24

3.2 Snacks

Children need a varied diet to ensure that they get all the nutrients they require for growth anddevelopment. Pre-school children often have small appetites and need regular meals with snacks inbetween (see section 2.1). Snacks should be nutritious and low in added sugars to prevent tooth decay.

There are some snack foods that can be harmful to children’s health if they are eaten frequently. Theseinclude soft drinks, sweets, chocolate confectionery, chocolate and cream-filled biscuits, sugarypastries, sugary desserts, highly-sweetened cereals, and sugary and sugared sticky yoghurts.

These types of snacks should not be provided in the pre-school care setting. If they must be givento children, they should be eaten at meal times only.



Suggestions for nutritious snacks

• Fruit: mouth-sized chunks, cubes or slices of apple, pear, satsuma, orange, banana, kiwi, melon,strawberries, sliced grapes, peaches and plums (for child-sized portions, see Appendix 4).

• Raw vegetables: carrot, pepper, celery, cucumber, sliced cherry tomato, red cabbage, turnip,radish, courgette, broccoli.

• Toast, breads, rolls, baps, French bread with a small amount of butter or spread; mini sandwicheswith marmite, cheese, tuna, banana, salad or thin slices of meat; pitta bread pockets cut intosmall slices; plain or with spread, e.g. olive or sunflower oil spread.

• Bread sticks – on their own or with a dip or soft cheese; homemade pizza triangles. • Oatcakes, rice cakes, crackers, crispbreads, melba toast: plain or with butter or spread, e.g.

sunflower or olive oil spread. • Natural yoghurt with fruit or fromage frais – on its own or as a dip. • Muffins, plain, potato or cheese scones, crumpets, pancakes, plain buns, plain popcorn, low-

sugar breakfast cereal.

Note: crisps or corn snacks, e.g. Quavers, Golden Lights, Wheat Crunchies, tortilla chips or Twiglets,can be offered as part of a snack or meal option as an alternative texture and taste, e.g. beside afilled sandwich or salad dish. However, they are high in salt and fat and therefore pre-schoolchildren should not be given them any more than twice a week (see section 2.3).

35

CASE STUDY

Happy Jack Project The Happy Jack project is operated by Edinburgh Community Food Initiative (ECFI) and works withfamilies with children between 4 months and 4 years through 12 Children and Family Centres inEdinburgh. The project provides children with over 1,600 portions of snack fruit and 2,400 pieces offruit to take home every week free of charge. In addition, fruit stalls have been established within eachcentre to provide low-cost, good-quality fruit and vegetables to parents.

The project provides a 5-week healthy eating cooking course for staff and parents which coversissues such as reading food labels, shopping on a budget and increasing the family fruit andvegetable intake.

All centres have received the Pip Project Activity Pack, which was created by staff at ECFI andcontains recipes, arts, crafts, songs, games and rhymes based on the most celebrated seasonal andcultural events. The pack is designed to complement the five key areas of the pre-5 curriculum andprovides advice and information on key nutritional issues for this age group.

The Happy Jack Project works in collaboration with a range of other local initiatives and partnersincluding Bookstart, music and movement groups, Lothian and Edinburgh Environmental Partnershipand oral health staff.

36

3.3 Drinks

It is important for pre-school children to have plenty to drink to help their bodies to functionproperly, keep cool and prevent constipation.

• Children should be encouraged to drink plain, still water at any time throughout the day. Plain, still water quenches thirst, replenishes body fluid, does not spoil the appetite and is not harmfulto teeth.

• Milk and water should be the only drinks taken between meals. From 1 year of age, whole cowsmilk should be the main milk drink until the child is at least 2 years old. From age 2, semi-skimmedmilk can be introduced as a main milk drink, provided the child is eating well. Fully skimmed milkis low in energy and low in some nutrients and for this reason is not suitable as a drink forchildren under the age of 5. From 5 years of age fully skimmed milk can be given. When only onetype of milk is provided (e.g. in the nursery setting) it should be whole milk.

• Fresh fruit juice is a good source of vitamin C and is best given with breakfast or a main meal tohelp with the absorption of iron. Fresh fruit juices are acidic and can cause dental erosion andtherefore should be served in a cup, not a bottle, and at meal times only.

• Children should be strongly discouraged from drinking sugared drinks frequently. There are anumber of reasons why these are unsuitable for pre-school children: they contribute to dentaldisease, they are a poor source of nutrition, they tend to displace other more nutritious foods,and they can result in poor energy balance. Examples of unsuitable drinks include: fizzy(carbonated) drinks including water, still sugary drinks, squashes and flavoured waters, cartons of sugared drinks, cordials for milk drinks.

• Fizzy, carbonated drinks which are sugar free are harmful to teeth due to their high acid content.• Tea and coffee are not recommended for children under 5 because they contain tannin and

caffeine. Tannin interferes with the absorption of iron.

3.4 Physical activity

All children, including children with disabilities, should have the opportunity to take part in physicalactivities, and the pre-school setting is important in contributing to the recommendation for at least1 hour of physical activity a day. Young children, given the chance, will do this as part of spontaneousplay, allowing them to have fun as well as improving physical health and social skills.

Encourage children to be active and plan opportunities for structured activity and unstructured activeplay on a daily basis. Having access to a range of physical activities encourages young children todevelop positive attitudes to the benefits of active living.

Ensure that activities are appropriate to children’s age and stage of development and check thatlinks are made with the Curriculum Framework for Children 3 to 5.7

You will find further information and lots of ideas in Let’s Make Scotland More Active.25



3.5 Vegetarian and vegan diets

Vegetarian diets

Vegetarians don’t eat fish or meat, but most will eat animal products, such as eggs, milk and dairyproducts. Provide food from the main food groups using the menu guidance. Choose alternativesto meat such as eggs, soya products (e.g. tofu), lentils, beans, including baked beans, chopped nutand nut pastes, seed pastes, meat substitutes (e.g. soya mince, quorn) and chickpeas (e.g. falafel,hummus).

Ask parents/guardians about foods that the child is familiar with at home, or about particular foodsto be avoided, e.g. gelatine and rennet.

Vegetarian meals and snacks are suitable for all children.

Vegan diets do not include any food from animal sources, therefore, in addition to meat and fish, theyexclude dairy produce, eggs and honey. This makes meeting the nutritional needs of the child morecomplex and they should be discussed with the parents and/or guardians.

Meeting iron requirements on a vegetarian diet

As meat is one of the main sources of iron it is important that vegetarian and vegan children eat otheriron-rich foods such as wholemeal bread, breakfast cereals, pulses, beans, peas, dried fruits, fortifiedcereals, and dark green vegetables, especially broccoli. Fresh fruit and vegetables and fresh fruitjuice are rich in vitamin C, which enhances the uptake of iron in the body. Tea and coffee interferewith the absorption of iron and for this reason are not suitable for young children.

3.6 Food choices and religious faiths and beliefs

Families may choose to exclude, include, or prepare foods in a particular way according to theirreligious faith and beliefs. Appendix 5 provides guidance on food choices for specific religious groups.This gives general guidance only as there will be individual differences and varying levels of adherenceto religious laws which should be discussed for each child with his or her parent or guardian.

3.7 Children with special needs or therapeutic diets

Some children will need the food they are offered to be modified. There are a number of possiblereasons for this, e.g. special needs and therapeutic diets, including those for allergies.

Children with special needs may need to have their food prepared in a particular way to make it easierto eat. They may use specially designed cutlery. In some cases they may need to have a structuredeating pattern.

For children on a therapeutic diet, the parent/guardian or registered dietitian will supply the staff orcarer with details of the child’s dietary needs, including suitable food choices for meals and snacks,foods that should be excluded or specifically included, or supplements that are required.

Therapeutic diets for food allergies are not uncommon in pre-school children. Foods commonlyassociated with allergies are milk, wheat, peanuts, fish, soya, eggs, shellfish, citrus fruits, seeds andnuts. A wide range of symptoms can occur when a child is exposed to an allergen in food, rangingfrom a mild reaction to a very rapid and severe response.

37

38

When a child has a severe allergy to a particular food you may decide to minimise the risk of exposureby avoiding having the food/ingredient in the pre-school setting. In severe cases it is essential thatthere is regular access to up-to-date advice from a registered dietitian because ingredients inprocessed foods change frequently.

All children, regardless of special or therapeutic dietary needs, should enjoy food and choosing andexperimenting with different foods.

3.8 Vitamin supplementation

Some children may receive vitamin drops, containing vitamins A, D and C. This is the responsibilityof parents and guardians and can be discussed with them. However, it will be useful for staff andcarers to be aware of current advice on children who may benefit from vitamin drops.

For children aged 1 to 5, the current advice for vitamin supplements is to take vitamins A, D andC.26,27 Children who are at risk of vitamin deficiency include: persistent poor eaters, children whoeat a very limited number of foods, those on restricted diets by choice, vegans and children onrestricted diets because of food allergy or intolerance.

There are important issues regarding intake of vitamin D and vitamin D requirements in the Scottishpopulation because we are so far north and have so little sunlight, especially during winter28 (seeAppendix 2).

There is no need to give young children aged 1 to 5 years other more complex multivitamin and/ormineral preparations unless they are on a special or therapeutic diet and it has been advised by adoctor or registered dietitian.


4 Putting nutritional guidanceinto practice

39

40

Putting the nutritional guidance into practice is the responsibility of everyone involvedwith children in the early years setting.

4.1 Working in partnership

Working in partnership with all those involved in caring for children, in particular parents and guardians,to encourage and support them to provide a balanced, nutritious diet will get the best results.

Developing and maintaining good relationships with parents, guardians, staff who support the earlyyears sector, and, most importantly, the children themselves is essential to ensure that the nutritionalguidance is given the support and endorsement it needs.

It is also worthwhile exploring other partnerships with individuals and organisations that may be ableto help put the nutritional guidance into practice at a local level, e.g. activity groups for children,voluntary sector groups for children, summer clubs, etc.


CASE STUDY

Lanarkshire’s Health Promoting Nursery Award Scheme(HPNAS)NHS Lanarkshire has worked with education partners in North and South Lanarkshire Councils tocreate an award scheme for Lanarkshire nurseries. This scheme mirrors the successful LanarkshireHealth Promoting School Award Scheme.

The HPNAS will co-ordinate health promotion activity in nurseries in Lanarkshire, in both the publicand private sector. The scheme has three levels: bronze, silver and gold. At bronze level, nurseries willaudit themselves and identify three priority areas for action, two priority areas at silver and one atgold. Early evidence shows that nutrition and promoting healthy eating will be identified as one of thepriority areas. The HPNAS team will support nurseries with personal contact and resources, includinga sample healthy eating policy. The team will promote Lanarkshire’s Nutrition and Oral Health Pack,distributed to all nurseries in 2003. The award scheme will also link with other local activities such asthe free fruit in nursery scheme, joint training for early years staff, andsupport for parents through practical cooking skills courses. Thescheme will have a positive impact on the health of children, staff,parents and carers in Lanarkshire.


4.2 Working alongside parents and guardians

As an early years carer, it is important to recognise that parents and guardians play a vital role insupporting your work, and together you have the potential to influence the eating habits of youngchildren. There are a number of ways that you can involve parents and guardians to take an interestin food and healthy eating. These could include:

• Early engagement with parents/guardians about individual needs which may impact on food choicesand intake during induction.

• Regular informal contact to let them know what their child has eaten and if he or she has eaten well.• Involving parents/guardians in developing and updating your policy (see section 4.3) on food and

health lets them know that you are committed to providing healthy, varied and enjoyable food aspart of childcare; it also lets them know what to expect and asks for their input.

• Making menus available to parents in advance so they can see what the child will receive that dayand plan other food in the day accordingly.

• Giving parents/guardians notice of changes to meals and food provision, allowing them to commenton menus.

• Inviting parents to share special recipes with you.• Providing storybooks with a food theme that parents can read at home with their child.

41

CASE STUDY

Food for TotThe Food for Tot project in Edinburgh provides parents and carers with information, knowledge andpractical skills to help them make informed choices for their family’s diet. Food for Tot is a jointinitiative between education, social work and health services to deliver nutrition courses through aresource pack for groups of parents with children under the age of 5. Courses are delivered in avariety of outreach settings, although support is also offered to parents on a one-to-one basis.

The project is funded by Sure Start and aims to:

• Develop dietary knowledge to help parents to make healthy food choices for themselves and theirchildren.

• Address parental concerns around how diet and health affect growth and development of babiesand young children.

• Build strategies to transfer what has been learned into the home environment.

• Develop parents’ self-esteem and confidence.

The Food for Tot project works in partnership with other professionals and projects including theinfant feeding advisor, Edinburgh Community Food Initiative, community dental team, health visitors,Books for Babies and the Early Communications Project.

42

4.3 Developing a food and nutrition policy

The recommendations and advice on food and nutrition should be understood and accepted by thestaff, carers, parents/guardians and those who provide food for the children. The best way to achievethis is to write down what the staff and carers aim to do with regard to food and drink. This helpsby allowing everyone a chance to discuss and agree the aims and add to or change what is decided,and it can be given out to new parents as information on the approach to healthy eating. This writteninformation (or policy) can then be updated as new information becomes available.

Here are some ideas for the sort of information you may wish to consider when developing a policy:


What types of food will you provide for the children?

What types of drinks will you provide for the children?

At meal and snack times …

Throughout the day …

At snack and meal times …

Healthy food items, low in sugar and salt, andincluding plenty of fruits and vegetables.

You could explain that a menu will be plannedby a member of staff with the knowledge andskills to do so and will be made available toparents (for example by placing on the nurserynotice board). The menu plan will include allmeals, snacks and drinks to be offered.

You could refer to the fact that you have usedthis Nutritional Guidance and Adventures inFoodland4 to develop your menu.

Plain, still water will be available throughout theday.

Fresh fruit juice diluted with water will beoffered only at meal times.

Milk and plain still water will be offered withsnacks and meals.


43

Who should see the policy? How will it be communicated to them?

What are you going to say about developing good eating habits?

What will you do if a child does not eat?

What advice will you give to parents about bringing food into the pre-school setting?

New parents and guardians, new staff, carersand caterers …

Ongoing …

Staff and carers …

If a child does not like the food …

If it is a continuing problem …

Bringing sweets and chocolates into the earlyyears setting …

You may decide to give a copy of the policy toall staff including new members of staff andparents.

The policy should contain a copy of the menucycle. Thereafter you might display weeklymenus on a notice board.

Encourage feedback from staff and parents.

Any changes to the policy could also be postedon the notice board.

Will encourage children to enjoy sitting andeating and drinking with others and helpingeach other with their food and drink (e.g. atsnack time pouring the drinks).

Children will not be expected to finisheverything on their plate and will be allowedseconds of fruits, bread or milk if still hungry.

Children who do not eat the food will be offeredan acceptable alternative, e.g. plain crackers,cheese, fruit, milk-based desserts.

Regular informal contact with parents will letthem know how their child has been eating andmake them aware of any difficulties.

Sweets and chocolates are not given tochildren. We ask parents not to give childrensweets or chocolates to bring into the nursery,including treats such as party bags containingsweets.

For the occasional very special celebrationchildren may receive these as part of the pre-school activities.

A sample food and nutrition policy is set out in Appendix 7.

4.4 Staff development and training

Effective early education and childcare requires a well-qualified workforce, all of whom should beproperly trained.29 Staff and carers will have differing training needs. All staff handling food will need training in food safety and hygiene18 and some will need to develop the knowledge and skillsfor menu planning, purchasing and preparation of food to ensure that the nursery meets NationalCare Standard 3.1

A staff development programme should assess the training needs of all staff and carers and offerappropriate training. Healthy eating should be an integral part of this training to support theimplementation of this guidance, enabling staff to develop an understanding of the nutritional needs of pre-school children and how the guidance can be applied practically in their setting.

Qualifications such as Scottish Vocational Qualifications (SVQs) and the Higher National Certificate(HNC) in Childcare and Education provide training opportunities for early years staff.

4.5 Monitoring and evaluation

Early education and child care settings are regulated by the Scottish Commission for the Regulationof Care, (the Care Commission) and Her Majesty’s Inspectorate of Education (HMIe). The NationalCare Standards for Early Education and Childcare up to the Age of 16 provide the framework forregulation and the Care Commission takes the lead role in inspection against Standard 3, whichincludes nutrition. Standard 3.4 requires that:

“Children and young people have access to a well-balanced and healthy diet (where food isprovided) which takes account of ethnic, cultural and dietary requirements, including foodallergies. Staff make sure that help with feeding is given in a way that best meets the needs of the child or young person.”

The Care Commission inspects the provision of food in early years settings as part of its inspectionprogramme. The standards will remain the tool that the Care Commission uses to monitor thequality of services. This guidance will contribute to this process by setting out what the ScottishExecutive considers to be a well-balanced and healthy diet.

The Scottish Executive and the Care Commission will continue to work together to raise thestandard of food provision for young children in care and education settings.

4.6 Areas for further consideration

During the consultation period, a number of areas were identified by respondents for furtherconsideration and development. These include assessing the nutritional status and intake of pre-school children in Scotland; the need to review evidence and current practice with regard tovitamin supplementation, in particular, the need to review the vitamin D status of pre-schoolchildren in Scotland; developing staff training to support implementation of this guidance; anddeveloping further resources such as advice for parents on packed lunches and physical activity.

44


Appendices

45

46

Appendix 1 Nutrient guidance for children aged 1 to 5yearsChildren, as individuals, have different energy and nutrient requirements depending on their age, gender,body size, rate of growth and level of activity. In the UK we have estimates for the average amountof energy and nutrients required for groups of children at different ages. These are known as the UKDietary Reference Values23 (DRVs). The nutrient guidance in Tables 1 and 2 is based on the UK DRVsfor groups of children aged 1 to 3 years and 3 to 5 years. The figures have been calculated from thedietary energy and nutrient reference values for boys, which are marginally higher than those for girls.As such, the nutrient guidance represents appropriate reference values for groups of children anddoes not apply to individuals.

Nutrient guidance is provided for one meal only (including drinks) (based on 30% of daily energy)and for a combined meal and snack (including drinks) (based on 40% of daily energy). Further guidancefor snacks and drinks is also provided in sections 3.2 and 3.3.

The values in Table 1 represent the recommended average energy and nutrient intake from one meal(based on an average taken over five meals). The values in Table 2 represent the recommendedaverage energy and nutrient intake from one meal and a snack (based on an average taken overfive meal/snack combinations). This would apply, for example, to a combined meal and snack (e.g. morning snack and lunch) provided for children who are in early years care or education. The average is taken over five days because energy and most nutrient requirements are met over a period of time, rather than within any one day.

To help with food choices and setting menus to meet the nutrient guidance, menu-planning guidanceand a sample 10 day menu is provided in sections 2.3 and 2.4. The menu is designed to meet theenergy and nutrient guidance (with the exception of salt and vitamin D – see Appendix 2). This is asample menu and does not cover the full range of food choices suitable for each age group. Theweights of foods used in the menu are given in Appendix 3.



47

Table 1: Energy and nutrient guidance for a meal providing 30% of daily energy. This would apply to,for example, lunch provided to children aged 1 to 5 years who are in early years care or education.

Nutrient 1-5 years Min/max Unit 1-3 4-5 years years

Energy 30% of EAR MJ 1.55 2.15(kcal) (371) (513)

Total fat No more than 40% of food energy for 1-3 years falling to 35% for 4-5 years g 17 20

Carbohydrate About 50% of food energy g 48 67

…of which NMESa No more than 11% of food energy Max g 10 13

Protein 30% of RNI Min g 4.4 5.9(Appendix 2)

Vitamin C Not less than 30% of RNI Min mg 9 9

Vitamin D (Appendix 2) Not less than 30% of RNI Min μg 2.1 NA

for 1-3 years only

Vitamin A Not less than 30% of RNI Min μg 120 120

Iron (Appendix 2) Not less than 30% of RNI Min mg 2.1 1.8

Calcium Not less than 30% of RNI Min mg 105 135

Zinc Not less than 30% of RNI Min mg 1.5 1.95

Sodium No more than 30% of SACN Max mg 236 353(Appendix 2) recommendation

Salt (NaCl) No more than 30% of SACN Max g 0.6 0.9recommendation

Fruit and No less than 30% of the Minvegetables recommendation

2-3 child-sized portions(Appendix 4)

Water Cool drinking water available throughout the day Min

EAR (estimated average requirement): the amount that satisfies 50% of the children in a group (defined by age and gender).RNI (reference nutrient intake): the amount of a nutrient that is sufficient to meet the dietary requirements for about 97% of thechildren in a group (defined by age and sometimes by gender). Intakes above this amount will almost certainly be adequate.Percentage of energy (%): energy in kilojoules (kJ) provided as fat, carbohydrate and non-milk extrinsic sugars.Scientific Advisory Committee on Nutrition (SACN): Salt and Health (2003) London www.sacn.gov.uk

a Added sugars: these are sometimes known as non-milk extrinsic sugars (NMES) or free sugars and are found in sweets, biscuits,soft drinks, breakfast cereals, table sugar, honey and fruit juice. They are not found in plain milk or in foods such as fruit and vegetables.

Table 2: Energy and nutrient guidance for a snack and meal combination. This would apply, forexample, to a morning snack and lunch provided to children aged 1 to 5 years who are in earlyyears care or education.

Nutrient 1-5 years Min/max Unit 1-3 4-5 years years

Energy 40% of EAR MJ 2.06 2.86(kcal) (493) (684)

Total fat No more than 40% of food g 22 27energy for 1-3 years falling to 35% for 4-5 years

Carbohydrate About 50% of food energy g 64 89…of which NMESa No more than 10% of food energy Max g 13 18

Protein 40% of RNI Min g 5.8 7.9(Appendix 2)

Vitamin C Not less than 40% of RNI Min mg 12 12

Vitamin D Not less than 40% of RNI for Min μg 2.8 NA (Appendix 2) 1-3 years only

Vitamin A Not less than 40% of RNI Min μg 160 160

Iron Not less than 40% of RNI Min mg 2.8 2.4(Appendix 2)

Calcium Not less than 40% of RNI Min mg 140 180

Zinc Not less than 40% of RNI Min mg 2 2.6

Sodium No more than 40% of SACN Max mg 314 471(Appendix 2) recommendation

Salt (NaCl) No more than 30% of SACN Max g 0.8 1.2recommendation

Fruit and No less than 40% of the Minvegetables recommendation

2-3 child-sized portions (Appendix 4)

Water Cool drinking water available Minthroughout the day

EAR (estimated average requirement): the amount that satisfies 50% of the children in a group (defined by age and gender).RNI (reference nutrient intake): the amount of a nutrient that is sufficient to meet the dietary requirements for about 97% of thechildren in a group (defined by age and sometimes by gender). Intakes above this amount will almost certainly be adequate.Percentage of energy (%): energy in kilojoules (kJ) provided as fat, carbohydrate and non-milk extrinsic sugars.Scientific Advisory Committee on Nutrition (SACN): Salt and Health (2003) London www.sacn.gov.uk

a Added sugars: these are sometimes known as non-milk extrinsic sugars (NMES) or free sugars and are found in sweets, biscuits,soft drinks, breakfast cereals, table sugar, honey and fruit juice. They are not found in plain milk or in foods such as fruit andvegetables.

48



49

Appendix 2 Menu planningProtein

The nutrient guidance for protein is for a meal to provide 30% of the daily RNI (Appendix 1, Table 1)and a meal and a snack combination to provide 40% of the RNI (Appendix 1, Table 2). When designinga menu, the protein content will usually work out higher than this, which is in line with eating patternsin the UK population and helps to provide sufficient iron and zinc in the diet.

Vitamin D

The UK Reference Nutrient Intake (RNI) for vitamin D for children aged 6 months to 3 years is 7 μgper day.23 For children 4 years and older there is no RNI because it is assumed that the action ofsunlight on the skin will ensure that sufficient vitamin D is available. Vitamin D status in pre-schoolchildren varies depending on the season of the year and a dietary supply of vitamin D is importantto maintain vitamin D status during autumn, winter and spring in Scotland.28,27 Vitamin D is alsoavailable from body stores. However, adequate body stores of vitamin D depend on regularexposure of the skin to sunlight during the summer months.

The children most at risk of low vitamin D status and deficiency are those living in northern latitudes(which includes Scotland) where there is inadequate sunlight for much of the year. In particularchildren with darker skin pigmentation, e.g. from Asian, Middle Eastern, African and Eastern Europeanfamilies, living in Scotland.28 This is because there is less synthesis of the bioactive form of vitaminD through the action of sunlight on darker skin.

Based on current dietary choices, achieving the dietary RNI of 7 μg per day (1 to 3 years old only)is unlikely without supplementation. Therefore, routine vitamin D supplementation is recommendedfor all children over 1 year of age and should be continued until 5 years unless the diet is diverseand plentiful.26,27

Iron

The nutrient guidance for iron is for a meal to provide 30% of the RNI and for a meal and snackcombination to provide 40% of the RNI. Children between the ages of 1 and 5 years have high ironrequirements because of their rapid growth and the need to build up iron stores. A high proportionof pre-school children in the UK have less than adequate iron intakes and iron deficiency anaemiais common in this age group.30,31 Iron deficiency can have lasting effects on health and development.32

Therefore, we need to improve the iron status of young children through adequate dietary intake.

In practice, achieving adequate iron intake is not easy and requires careful menu planning to ensurethat iron-rich foods are included on a regular basis.33 Red meats are the richest and most easilyabsorbed source of iron, however breakfast cereals fortified with iron are also an important sourceof iron for children. The formal childcare setting is an excellent opportunity to boost overall ironintakes by encouraging healthy eating.

Sodium

The nutrient guidance for sodium is for a meal to provide a maximum of 30% of the daily SACN34

recommendation (for age group 1 to 5 years) and the combination of a meal and snack to provide amaximum of 40%. The sample menus given in this document do not meet the nutrient guidance forsodium. This is because the majority of the sodium in the diet is found in processed food and alsoin bread. Although this may eventually be partly addressed by a decrease in the sodium content ofprocessed foods and breads, caterers can reduce salt intake by choosing low-salt foods and reducingthe salt used in cooking, e.g. making sauces from base ingredients, not adding salt to sauces andhomemade soups, choosing low salt varieties of tinned foods. Work is already under way withpartners in the food industry to reduce the salt content of processed foods and this will eventuallyhelp to reduce the sodium content of processed foods used in public sector catering.35 For furtherinformation and ideas on reducing sodium intake see the Food Standards Agency website.36

50



51

Day 1

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

por

ridge

(110

g)se

rved

with

milk

(50m

l)

toas

ted

who

lem

ealb

read

(sm

alls

lice,

25g)

with

spre

ad(5

g)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

min

iSco

tch

pan

cake

,(2

0g)

with

spre

ad(3

g)

tang

erin

e(5

0g)

Lunc

h

spag

hett

ibol

ogne

seb

(150

g,in

clud

ing

sauc

ean

dsp

aghe

tti)

with

add

edca

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s(4

0g)

cust

ard

(60g

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apric

ots

(50g

)

Mid

-aft

erno

on

snac

k

milk

(100

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1 /2

smal

lban

ana

(50g

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esh

app

le(5

0g)s

erve

dw

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lain

yogh

urt

asa

dip

(40g

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Tea

ched

dar

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ndto

mat

oes

(50g

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toas

ted

whi

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read

(45g

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spre

ad(5

g)

man

dar

inor

ange

sin

juic

e(5

0g)w

ithva

nilla

ice

crea

m(4

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2p

ure,

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ned

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(30m

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dw

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a

Wee

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ithsp

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(5g)

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(5g)

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(100

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bre

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(20g

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app

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(50g

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smal

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ad(3

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and

swee

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erve

dw

ithsl

iced

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oes

(30g

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dic

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cum

ber

(20g

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milk

jelly

(70g

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ped

with

chop

ped

pin

eap

ple

(40g

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milk

(100

ml)

min

ifru

itsc

one

(25g

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spre

ad(5

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1p

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(55g

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vege

tab

leso

up(1

50g)

crus

tyw

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bre

ad(4

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(5g)

cust

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(80g

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pea

ches

(50g

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3p

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unsw

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ned

oran

geju

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(30m

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a

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deg

gc(5

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smal

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eof

toas

ted

who

lem

ealb

read

(40g

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spre

ad(1

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milk

(100

ml)

toas

ted

teac

ake

(30g

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spre

ad(5

g)

por

kan

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saus

ageb

(gril

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)(40

g),

bak

edp

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o(7

5g),

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eans

(80g

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drie

dap

ricot

(15g

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rais

ins

(15g

)

milk

(100

ml)

fres

hb

anan

a(3

0g)

pla

infr

omag

efr

ais

(60g

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chic

ken

risot

tob

(150

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ithad

ded

mus

hroo

ms

(20g

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app

lecr

umb

le(7

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ithm

ilk(2

5ml)

4p

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unsw

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oran

geju

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(30m

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ithw

ater

a

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s(2

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ithm

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rais

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(20g

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smal

lslic

eof

toas

ted

whi

teb

read

(25g

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spre

ad(5

g)

milk

(100

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smal

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ana

(80g

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finge

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lect

ion,

e.g.

1 /2

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(50g

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(100

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min

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(40g

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min

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bee

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grav

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52


Day 5

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

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dilu

ted

with

wat

era

bak

edb

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(60g

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ted

muf

fin(4

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read

(5g)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

crum

pet

(20g

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spre

ad(5

g)

fres

hp

each

(50g

)

Lunc

h

who

lem

ealr

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50g)

with

spre

ad(7

g),

fille

dw

ithha

mb

(30g

)tom

ato

(35g

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serv

edw

ithca

rrot

stic

ks(3

0g)

app

lesp

onge

pud

din

g(5

0g)

Mid

-aft

erno

on

snac

k

milk

(100

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pin

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ple

inju

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(50g

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som

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yogh

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(40g

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Tea

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lmon

b(5

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aste

dw

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oil(

5g)w

ithne

wp

otat

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(100

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dgr

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bea

ns(4

0g)

frui

tfr

omag

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ais

(60g

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rved

with

stra

wb

errie

s(4

0g)

6p

ure,

unsw

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ned

oran

geju

ice

(30m

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a

puf

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at(2

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ithm

ilk(5

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whi

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(sm

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ithsp

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,(5

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dja

m(8

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(100

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grap

es(3

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ban

ana

(30g

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elon

(30g

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lean

bee

fst

ewb

(90g

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boi

led

pot

atoe

s(1

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rnip

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led

(30g

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rrot

s(3

0g)

frui

tcr

umb

le(6

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ndcu

star

d(4

0g)

wat

er

muf

fin(3

5g)

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le(3

0g)

ciab

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(35g

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dar

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mat

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(50g

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frui

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inju

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(60g

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7p

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unsw

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(30m

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a

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(110

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(50m

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t(1

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(100

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pla

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(25g

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erin

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ab

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(35g

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(45g

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n(2

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lain

yogh

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(20g

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rved

with

tom

atoe

s(2

0g)

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jelly

(90g

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man

dar

inor

ange

s(5

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milk

(100

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chop

ped

carr

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(30g

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er(3

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liced

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ryto

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oes

(30g

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Sp

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te(8

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aked

pot

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s(8

0g)

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lep

ie(6

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ithva

nilla

ice

crea

m(4

0g)

8p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

grill

edb

acon

b(2

5g)w

ithsl

iced

tom

ato

(50g

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smal

lslic

eof

toas

ted

who

lem

ealb

read

(25g

)with

spre

ad(1

0g)

milk

(100

ml)

ban

ana

(80g

)

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

crus

tyb

read

(40g

)with

spre

ad(1

0g)

sard

ines

(40g

)with

slic

edto

mat

o(5

0g)

1ca

rton

frui

tyo

ghur

tw

ith6

chop

ped

grap

es

milk

(100

ml)

Sco

tch

pan

cake

s(2

0g)w

ithsp

read

stra

wb

errie

s(4

0g)

lent

ilso

up(1

50g)

who

lem

ealb

read

(25g

)with

spre

ad(5

g),

cold

roas

ttu

rkey

b(2

5g)w

ithle

ttuc

e(1

0g),

slic

edto

mat

oes

(50g

)an

dcr

anb

erry

sauc

e(1

0g)

Me

nu

2:

A1

0-d

ay

me

nu

wit

hw

eig

hte

dp

ort

ion

sfo

rc

hil

dre

na

ge

d1

to3

yea

rs


53

aW

esu

gges

tth

atp

ure,

unsw

eete

ned

oran

geju

ice

isd

ilute

dab

out

50:5

0ju

ice

tow

ater

thro

ugho

ut.

How

ever

,it

can

be

serv

edun

dilu

ted

,or

with

agr

eate

rp

rop

ortio

nof

wat

erto

juic

eif

alo

nger

,m

ore

thirs

t-q

uenc

hing

drin

kis

pre

ferr

ed.

bFo

rve

geta

rian

optio

nsfo

rm

eat,

fish

and

chic

ken

the

follo

win

gca

nb

eus

edas

sub

stitu

tes:

for

bee

fst

ew,

bee

fco

uld

be

sub

stitu

ted

with

chic

kpea

sor

kid

ney

bea

ns;

inb

olog

nese

,m

eat

coul

db

esu

bst

itute

dw

ithso

yam

ince

;ch

eese

,hu

mm

usor

egg

coul

dre

pla

cetu

na;

chic

ken

coul

db

esu

bst

itute

dw

ithle

ntils

orch

ickp

eas.

Oth

ersu

itab

lesu

bst

itute

sar

eve

ggie

saus

ages

,q

uorn

,p

eanu

tb

utte

r,b

aked

bea

ns,

chee

sean

db

ean

bur

gers

.c

Whe

refr

esh

eggs

are

not

used

toav

oid

the

risk

ofS

alm

onel

la,

slic

edha

rd-b

oile

deg

gsan

dsc

ram

ble

deg

gsca

nb

esu

bst

itute

dw

ithd

ried

pow

der

edeg

g.d

The

spre

adus

edis

mon

ouns

atur

ated

orp

olyu

nsat

urat

ed–

this

app

lies

toal

lref

eren

ces

to‘s

pre

ad’

thro

ugho

utth

ed

ocum

ent.

Day 9

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

por

ridge

(110

gm

ade

with

milk

)ser

ved

with

milk

(50m

l)

smal

lslic

eof

toas

ted

whi

teb

read

(25g

)with

spre

ad(5

g)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

chee

sesc

one

(25g

)with

spre

ad(1

0g)a

ndsl

iced

cher

ryto

mat

oes

(45g

)

Lunc

h

mild

chic

ken

korm

ab(9

0g)

with

boi

led

rice

(80g

)and

naan

bre

ad(2

5g)

frui

tyo

ghur

t(6

0g)

Mid

-aft

erno

on

snac

k

milk

(100

ml)

ban

ana

(80g

)or

finge

rfo

odse

lect

ion:

chop

ped

ban

ana

(30g

),ap

ple

(30g

)and

oatc

ake

(15g

)

Tea

min

iwho

lem

ealr

oll(

30g)

with

spre

ad(1

0g),

slic

edha

rd-b

oile

deg

gc(5

0g)s

liced

tom

ato

(35g

)and

mus

tard

and

cres

s

spon

gep

udd

ing

(50g

)and

frui

tco

ckta

il(4

0g)

10p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

scra

mb

led

eggc

(60g

)on

who

lem

ealt

oast

(25g

)with

spre

ad(5

g)

wat

er

pla

infr

omag

efr

ais

(60g

)

plu

ms

(30g

)

vege

tab

lela

sagn

e(1

60g)

garli

cb

read

(25g

)

rice

pud

din

g(1

00g)

with

pur

eed

app

les

(30g

)

milk

(100

ml)

crea

mcr

acke

rs(1

0g)w

ithch

edd

arch

eese

(15g

)and

app

le(4

0g)

min

estr

one

soup

(150

g)

whi

teb

read

toas

ted

(45g

)w

ithsp

read

(10g

),ha

mb

(25g

),an

dp

inea

pp

le(4

0g)

Me

nu

2:

A1

0-d

ay

me

nu

wit

hw

eig

hte

dp

ort

ion

sfo

rc

hil

dre

na

ge

d1

to3

yea

rs

54


Day 1

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

por

ridge

mad

ew

ithm

ilk(1

40g)

serv

edw

ithm

ilk(5

0ml)

toas

ted

who

lem

ealb

read

smal

lslic

e(2

5g)w

ithsp

read

(10g

)and

jam

(15g

)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

min

iSco

tch

pan

cake

(30g

)w

ithsp

read

(10g

)

tang

erin

e(5

0g)

Lunc

h

spag

hett

ibol

ogne

seb

(200

g,in

clud

ing

sauc

ean

dsp

aghe

tti)

with

add

edca

rrot

s(4

0g)

cust

ard

(100

g)an

dap

ricot

s(5

0g)

Mid

-aft

erno

on

snac

k

milk

(100

ml)

1 /2

smal

lban

ana

fres

hap

ple

(65g

)ser

ved

with

pla

inyo

ghur

tas

ad

ip(8

0g)

Tea

ched

dar

chee

se(4

5g)o

nto

aste

dw

hite

bre

ad(4

5g)

with

spre

ad(1

5g)t

omat

oes

(50g

)

man

dar

inor

ange

sin

juic

e(5

0g)w

ithva

nilla

ice

crea

m(5

0g)

2p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

Wee

tab

ix(3

0g)w

ithm

ilk(1

00m

l)

smal

lslic

ew

hole

mea

ltoa

st(2

5g)w

ithsp

read

(10g

)and

jam

(15g

)

milk

(100

ml)

bre

adst

icks

(25g

)ch

eese

cub

es(1

5g)

app

lech

unks

(50g

)

smal

lwho

lem

ealp

itta

bre

ad(7

5g)w

ithro

ast

chic

kenb

(50g

)and

swee

tcor

n(3

5g)s

erve

dw

ithsl

iced

cher

ryto

mat

oes

(35g

)an

dd

iced

cucu

mb

er(2

0g)

milk

jelly

(110

g)w

ithch

opp

edp

inea

pp

le(7

0g)

milk

(100

ml)

min

ifru

itsc

one

(25g

)with

spre

ad(1

0g)

1p

lum

(55g

)

vege

tab

leso

up(2

20g)

crus

tyw

hite

bre

ad(5

0g)

spre

ad(5

g)

cust

ard

(100

g)an

dp

each

es(6

0g)

3p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

slic

edha

rd-b

oile

deg

gc

(50g

)sm

alls

lice

ofto

aste

dw

hole

mea

lbre

ad(4

0g)w

ithsp

read

(15g

)

milk

(100

ml)

toas

ted

teac

ake

(50g

)

por

kan

db

eef

saus

ageb

(gril

led

)(55

g),

bak

edp

otat

o(1

00g)

,b

aked

bea

ns(8

0g)

drie

dap

ricot

(20g

)ra

isin

s(2

0g)

milk

(100

ml)

fres

hb

anan

a(3

0g)

pla

infr

omag

efr

ais

(60g

)

chic

ken

risot

tob

(180

g)w

ithad

ded

mus

hroo

ms

(30g

)

app

lecr

umb

le(9

5g)a

ndm

ilk(2

5ml)

4p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

corn

flake

s(3

0g)w

ithm

ilk(1

00m

l)an

dra

isin

s(2

0g)

slic

eof

toas

ted

whi

teb

read

(35g

)with

spre

ad(5

g)

milk

(100

ml)

smal

lban

ana

(50g

)

grap

es(2

0g)

slic

edha

rd-b

oile

deg

gc(5

0g)

with

who

lem

ealb

read

sold

iers

(60g

)bre

adw

ithsp

read

(15g

)

rice

pud

din

g(1

50g)

with

sulta

nas

(20g

)

milk

(100

ml)

min

imuf

fin(4

0g)w

ithsp

read

(10g

)

mel

onsl

ices

(40g

)

min

ced

bee

fbin

grav

y(1

50g)

,m

ashe

dp

otat

oes

(120

g),

bro

ccol

i(50

g)

frui

tco

ckta

ilin

juic

e(9

0g)

Me

nu

3:

A1

0-d

ay

me

nu

wit

hw

eig

hte

dp

ort

ion

sfo

rc

hil

dre

na

ge

d3

to5

yea

rs


55

Day 5

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

bak

edb

eans

(80g

)to

aste

dm

uffin

(50g

)with

spre

ad(1

5g)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

crum

pet

(40g

)with

spre

ad(1

0g)

fres

hp

each

(50g

)

Lunc

h

who

lem

ealr

olls

(60g

)with

spre

ad(1

5g),

fille

dw

ithha

mb

(30g

),to

mat

o(3

5g)

and

serv

edw

ithca

rrot

stic

ks(3

5g)

app

lesp

onge

pud

din

g(9

0g)

Mid

-aft

erno

on

snac

k

wat

er

pin

eap

ple

inju

ice

(80g

)se

rved

with

pla

inyo

ghur

t(8

0g)

Tea

grill

edsa

lmon

b(7

5g)b

aste

dw

ithol

ive

oil(

10g)

with

boi

led

pot

atoe

s(1

00g)

and

gree

nb

eans

(50g

)

frui

tfr

omag

efr

ais

(60g

)se

rved

with

stra

wb

errie

s(4

0g)

6p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

puf

fed

whe

at(3

0g)w

ithm

ilk(1

00m

l)

toas

ted

whi

teb

read

(sm

all

slic

e35

g)w

ithsp

read

(5g)

and

jam

(10g

)

milk

(100

ml)

grap

es(3

0g)

ban

ana

(30g

)m

elon

(30g

)

lean

bee

fst

ewb

(105

g)w

ithb

oile

dp

otat

oes

(100

g),

turn

ipb

oile

d(4

0g)a

ndca

rrot

s(4

0g)

frui

tcr

umb

le(9

5g)a

ndcu

star

d(6

0g)

wat

er

muf

fin(4

0g)

app

le(5

0g)

ciab

atta

(50g

)with

ched

dar

chee

se(3

5g)a

ndto

mat

oes

(50g

)

frui

tyo

ghur

t(1

25g)

with

pea

rsin

juic

e(8

0g)

7p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

por

ridge

(130

gm

ade

with

milk

)ser

ved

with

milk

(100

ml)

smal

lslic

eto

ast

(25g

)with

spre

ad(1

0g)

milk

(100

ml)

pla

insc

ones

(25g

)with

spre

ad(1

0g)

tang

erin

e(5

0g)

pitt

ab

read

(75g

)fill

edw

ithtu

nab

(45g

)and

swee

tcor

n(4

0g)w

ithp

lain

yogh

urt

(40g

)se

rved

with

tom

atoe

s(5

0g)

milk

jelly

(150

g)to

pp

edw

ithm

and

arin

oran

ges

(50g

)

milk

(100

ml)

crac

kers

(10g

)

pla

inyo

ghur

t(8

0g)

chop

ped

carr

ots

(35g

),cu

cum

ber

(30g

)and

slic

edch

erry

tom

atoe

s(4

5g)

Sp

anis

hom

elet

tec

(120

g),

bak

edp

otat

oes

(110

g)

app

lep

ie(9

0g)a

ndva

nilla

ice

crea

m(4

0g)

8pu

re,u

nsw

eete

ned

oran

geju

ice

(30m

l)di

lute

dw

ithw

ater

a

grill

edb

acon

b(2

5g)w

ithsl

iced

tom

ato

(60g

)

smal

lslic

eof

toas

ted

who

lem

ealb

read

(40g

)with

spre

ad(1

0g)

milk

(100

ml)

milk

(100

ml)

ban

ana

(100

g)

crus

tyb

read

(50g

)with

spre

ad(1

0g)

sard

ines

b(5

0g)w

ithsl

iced

tom

ato

(50g

)

frui

tyo

ghur

t(1

25g)

chop

ped

grap

es(3

0g)

milk

(100

ml)

Sco

tch

pan

cake

s(3

0g)w

ithsp

read

(5g)

stra

wb

errie

s(5

0g)

lent

ilso

up(1

70g)

who

lem

ealb

read

(70g

)with

spre

ad(1

0g),

cold

roas

ttu

rkey

b(4

5g)w

ithle

ttuc

e(2

0g),

slic

edto

mat

oes

(50g

)an

dcr

anb

erry

sauc

e(2

0g)

Me

nu

3:

A1

0-d

ay

me

nu

wit

hw

eig

hte

dp

ort

ion

sfo

rc

hil

dre

na

ge

d3

to5

yea

rs

56


Day 9

Bre

akfa

st

pur

e,un

swee

tene

dor

ange

juic

e(3

0ml)

dilu

ted

with

wat

era

por

ridge

(140

gm

ade

with

milk

)ser

ved

with

milk

(100

ml)

smal

lslic

eof

toas

ted

whi

teb

read

(40g

)with

spre

ad(1

0g)

Mid

-mo

rnin

gsn

ack

milk

(100

ml)

chee

sesc

one

(40g

)with

spre

ad(1

0g)a

ndsl

iced

cher

ryto

mat

oes

(45g

)

Lunc

h

mild

chic

ken

korm

ab(1

00g)

with

boi

led

rice

(100

g)an

dna

anb

read

(50g

)

frui

tyo

ghur

t(8

0g)

Mid

-aft

erno

on

snac

k

milk

(100

ml)

ban

ana

(50g

)ap

ple

(50g

)oa

tcak

e(1

5g)

Tea

min

iwho

lem

ealr

oll(

50g)

with

spre

ad(1

0g),

slic

edha

rd-b

oile

deg

gc(5

0g),

tom

ato

(35g

)and

mus

tard

and

cres

s

spon

gep

udd

ing

(90g

)and

frui

tco

ckta

il(6

0g)

10p

ure,

unsw

eete

ned

oran

geju

ice

(30m

l)d

ilute

dw

ithw

ater

a

scra

mb

led

eggc

(70g

),to

ast

(35g

)with

spre

ad(1

0g)

wat

er

pla

infr

omag

efr

ais

(100

g)

plu

ms

(55g

)

vege

tab

lela

sagn

e(1

80g)

garli

cb

read

(40g

)

rice

pud

din

g(1

50g)

with

pur

eed

app

les

(30g

)

milk

(100

ml)

crea

mcr

acke

rs(1

5g)w

ithch

edd

arch

eese

(25g

)and

app

le(5

0g)

min

estr

one

soup

(170

g)

whi

teb

read

toas

ted

(55g

)w

ithsp

read

(15g

),ha

mb

(30g

)and

pin

eap

ple

(40g

)

Me

nu

3:

A1

0-d

ay

me

nu

wit

hw

eig

hte

dp

ort

ion

sfo

rc

hil

dre

na

ge

d3

to5

yea

rs

aW

esu

gges

tth

atp

ure,

unsw

eete

ned

oran

geju

ice

isd

ilute

dab

out

50:5

0ju

ice

tow

ater

thro

ugho

ut.

How

ever

,it

can

be

serv

edun

dilu

ted

,or

with

agr

eate

rp

rop

ortio

nof

wat

erto

juic

eif

alo

nger

,m

ore

thirs

t-q

uenc

hing

drin

kis

pre

ferr

ed.

bFo

rve

geta

rian

optio

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57

Appendix 4 Children’s fruit and vegetable portion sizesThe fruit and vegetable portion sizes for pre-school children are derived from the portion size guidefor adults used in the Scottish Health Survey 2004 and the Health Survey for England 2003. Theyare approximately one- to two-thirds of an adult portion:

Vegetables (fresh, frozen or canned) 25-50g, 1-2 heaped tablespoons

Pulses 25-50g, 1-2 heaped tablespoons

Salad 1/4-1/2 cereal bowlful

Vegetables in composites, such as 25-50g, 1-2 heaped tablespoons per portion of vegetable chilli the recipe

Banana 30-60g, 1/2-1 small

Very large fruit, such as melon 1/2-1 small slice

Large fruit, such as grapefruit 1/2 fruit

Medium fruit, such as apples 25-50g, 1/4-1/2 fruit

Small fruit, such as plum 25-50g, 1/2-1 fruit

Very small fruit, such as blackberries 1/2-1 average handful

Dried fruit 1/2 tablespoon

Fruit in composites, such as stewed fruit 30-60g, 1-2 heaped tablespoons per portion of in apple pie the recipe

Frozen fruit/canned fruit 30-60g, 1-2 heaped tablespoons

Fruit juice 1/2-1 small glass (100-150ml)

Children’s portion sizes for a wide range of foods have been established from dietary survey datafrom the UK national surveys of children. They will be published by the Food Standards Agencyearly in 2006.37

Appendix 5 Food for religious faiths and beliefsFamilies and children may choose to exclude, include, or prepare foods in a particular way accordingto their religious faith and beliefs.

The guidance given below on food choices for specific religious groups is very general. There will beindividual differences and varying levels of adherence to religious laws which should be discussedfor each child with his or her parent or guardian.

58


Meat PoultryFish andShellfish

DairyProducts

EggsFruit andVegetables

Miscellaneous Fasting

Buddhist Many are vegetarian but some may eat fish.Some may be vegan.

Some mayexclude.

Yes Diet will varydepending on countryof origin.

Yes

Hindu Most are vegetarian. Dairy is generallyacceptable.Those who eat meat, poultry, and fish willexclude beef.

Some maybe vegan.Some mayexclude.

Yes Strict hindus alsoexclude:Tea and CoffeeAlcohol

Yes

Jewish Pork and pork products are excluded.Kosher beef, lamb, poultry and fish (with finsand scales) are eaten. Shellfish is not eaten.Meat and dairy are never eaten at the samemeal. Dairy may not be eaten until 3 hoursafter meat or poultry.

Eggs can beeaten withoutblood spots.

Yes Will also exclude:Gelatin, Fats,Emulsifiers, stabilisers,and additives fromanimal origin that isnot kosher.

Yes

Muslim Pork and pork products are excluded.Halal beef, lamb, poultry, fish are eaten.Dairy products are eaten by most.

Yes Yes Will also exclude:Gelatin, Fats,Emulsifiers, stabilisers,and additives fromanimal origin that isnot halal.Alcohol

Yes

Sikh Many are vegetarian.Those who eat meat, poultry and fish willexclude beef and possibly pork.Halal and kosher meat are not eaten.

Some mayexclude.

Yes No

Rastafarian Pork and pork products are excluded.Many will be vegetarian.Some may be vegan.

Some mayexclude.

Yes Prefer to eat a pureand natural diet somay exclude:coffee, alcohol,canned or non-organicfoods.

Yes

Note 1: Some people within some of the faith groups identified may not observe the dietary laws stated above. Prohibitions andrestrictions even within a particular faith may change between denominations or branches. Please do not take this as anauthoritative list. This page is meant as a guide only.

Note 2: Tea and coffee are not recommended for children under 5 for nutritional reasons (see section 3.3). Information about alcoholis included in this table for completeness in relation to the diets of adult members of the faith groups only.


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Appendix 6 Putting it into practiceMenu planning checklist

Once you have planned your menu you may wish to use this checklist to ensure that you’ve coveredthe key points. The comprehensive menu planning guidance in section 2.3 provides more detail.

• Fruit and/or vegetables will be offered at each lunch and tea.• Each meal (lunch and tea) will contain at least one food from the starchy food group (i.e. bread,

rice, pasta, other cereals or potatoes).• Each meal (lunch and tea) will contain at least one of the following: meat, fish, eggs, pulses,

seeds and nuts, cheese. A variety of these foods should be offered over a week. • High-fat, processed potato products (e.g. croquettes, waffles, smiley faces or other shaped

products and chips) will be served no more than once in a full 5-day menu. • Milk, cheese or yogurt will be offered daily.• Puddings will be fruit- or milk-based and low in added sugar.• A mixture of hot and cold foods will be offered.• The only drinks offered at snack time will be milk or water.• Fruit juice and dried fruit will be offered at meal times only.• Snacks will be healthy, varied, and low in added sugars and should include fresh fruit or

vegetables most of the time.• Meals and snacks will not include sweets, chocolate or fizzy drinks.

Appendix 7 Sample food and nutrition policy• The weekly snack and lunch menu will be on display in advance. Nursery recipes will be available

on request.• The weekly menu will provide children with a varied and healthy diet.• All children will be offered suitable foods; this will include children with special dietary

requirements and allergies. • Early session children who do not receive breakfast at home will be offered this when they arrive

in agreement with parents or guardians.• Milk or water will be served with morning and afternoon snacks.• All dairy products used in the nursery will be full fat.• Water will be available at all times.• Milk, water or diluted fresh fruit juice will be served with the main meal.• Children will be allowed to have second helpings of fruit- or milk-based desserts if available.• Children will still receive dessert if they refuse their main course.• Parents or guardians will be advised if their child is not eating well.• Advice will be given to parents about suitable food to bring from home, including suitable party

foods and healthy options for packed lunches.• Parents of children who are on special diets will be asked to provide as much written information

as possible about suitable foods, and in some cases may be asked to provide the foodthemselves. A photograph of any child with a special dietary requirement or allergy will bedisplayed in the food preparation area to ensure that permanent and supply staff are aware ofeach individual child’s needs.

• Carers will sit with children while they eat and will provide a good role model for healthy eating.• Withholding food will not be used as a form of punishment.• Children will be encouraged to develop good eating skills and table manners and will be given

plenty of time to eat.• Children will be encouraged to play outside everyday, weather permitting. Parents will be asked

to provide sunscreen for their child when necessary.

This policy will be reviewed annually and updated as necessary by the Nursery Health Promotion Group.

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Appendix 8 Working groupThe working group was convened by NHS Health Scotland to produce the draft guidelines forconsultation.

Julie Armstrong Lecturer in Nutrition, Glasgow Caledonian University, seconded to NHS Health Scotland

Cathy Higginson Health Improvement Programme Manager (Food and Nutrition), NHS Health Scotland

Fiona MacDonald Senior Health Promotion Officer (Food and Health), NHS Argyll and Clyde

Ruth Campbell Public Health Nutritionist, NHS Lanarkshire

Jennie Jackson Lecturer in Human Nutrition and Dietetics, Glasgow Caledonian University

Helen Bennewith Research Student, Glasgow Caledonian University

Gillian Kynoch Scottish Food and Health Co-ordinator, Scottish Executive

Appendix 9 References and resources1 Scottish Executive. National Care Standards – Early Education And Childcare up to the Age of

16; Standard 3 Health and Wellbeing. Scottish Executive, Edinburgh, 2002.http://www.scotland.gov.uk/library5/education/ncsee.pdf. The standards have been developedfrom the point of view of the user of the service and focus on what they should receive.

2 NHS Health Scotland. Off to a Good Start: All you need to know about breastfeeding your baby.NHS Health Scotland, Edinburgh, 2004. Please email [email protected] or phonethe publications office at NHS Health Scotland on 0131 536 5500.

3 NHS Health Scotland. Fun First Foods. NHS Health Scotland, Edinburgh, 2004. Please [email protected] or phone the publications office at NHS Health Scotland on0131 536 5500.

4 NHS Health Scotland. Adventures in Foodland. NHS Health Scotland, Edinburgh, 2003. Pleaseemail [email protected] or phone the publications office at NHS Health Scotlandon 0131 536 5500.

5 Scottish Executive. Health for all Children: Guidance for implementation for children. ScottishExecutive, Edinburgh, 2005. http://www.scotland.gov.uk/Publications/2005/04/15161325/13269

6 Scottish Executive. Improving Health in Scotland – the Challenge. Scottish Executive,Edinburgh, 2003. http://www.scotland.gov.uk/Publications/2003/03/16747/19930.

7 Scottish Executive. Eating for Health – Meeting the Challenge: Co-ordinated action, improvedcommunication and leadership for Scottish food and health policy 2004, Strategic Frameworkfor Food and Health 2004–2005. Scottish Executive, Edinburgh, 2004.http://www.scotland.gov.uk/Resource/Doc/47060/0012960.pdf.

8 The Scottish Consultative Council. A Curriculum Framework for Children 3 to 5. The ScottishConsultative Council, Edinburgh, 1999.http://www.ltscotland.org.uk/earlyyears/resources/publications/ltscotland/framechildren3to5.asp#1. This gives national advice and guidance on the learning and development needs of youngchildren for all centres involved in the education of children aged 3 to 5.

9 Scottish Executive. Closing the Opportunity Gap. Scottish Executive, Edinburgh, 2005.http://www.scotland.gov.uk/topics/people/social-inclusion/17415/opportunity.

10 Alaimo K, Olson CM, Frongillo EA Jr, Briefel RR. Food insufficiency, family income, and healthin US preschool and school-aged children. American Journal of Public Health 2001; 91: 781-811.

11 Harris RJ. Nutrition in the 21st century: what is going wrong? Archives of Disease in Childhood2004; 89: 154-158.

12 Higginson, C. Evidence into Action: Nutrition in the under-fives. Health Education Board forScotland (HEBS, now NHS Health Scotland), Edinburgh, 2001.http://www.hebs.scot.nhs.uk/researchcentre/pdf/Infant_nutrition_Evidence_into_action.pdf.

13 Grantham-McGregor SM, Walker SP, Chang S. Nutritional deficiencies and later behaviouraldevelopment. Proceedings of the Nutrition Society 2000; 59: 47-54.

14. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sensecure. Lancet 2002; 360: 473-482.

15. World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases. Report of ajoint WHO/FAO Expert consultation. WHO Technical Report Series, WHO, Geneva, 2003.

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16 Walker SP, Grantham-Mcgregor SM, Powell CA, Chang SM. Effects of growth restriction in earlychildhood on growth, IQ, and cognition at age 11 to 12 years and the benefits of nutritionalsupplementation and psychosocial stimulation. Journal of Paediatrics 2000; 137: 36-41.

17 Benton D. Role of parents in the determination of the food preferences of children and thedevelopment of obesity. International Journal of Obesity and Related Metabolic Disorders 2004;28: 858-869.

18 Food Standards Agency’s Eatwell website: www.eatwell.gov.uk. Publications can be obtainedfrom the FSA by visiting www.food.gov.uk/aboutus/publications or by writing to Food StandardsAgency Scotland, 6th Floor, St Magnus House, 25 Guild Street, Aberdeen AB10 6NJ. If youcan’t find the answers you are looking for on the website or in any of the publications, thenemail the Food Standards Agency Scotland direct at [email protected]

19 Scottish Executive. Nutrition in Schools: Scottish nutrient standards for school lunches. Nutrientspecifications for manufactured products. Scottish Executive, Edinburgh, 2005.http://www.scotland.gov.uk/library5/education/niss-05.asp

20 Levine, RS. Milk, flavoured milk products and caries. British Dental Journal 2001; 191: 1.

21 Scientific Advisory Committee on Nutrition (SACN). Advice on Fish Consumption: Benefits andrisks. SACN, London, 2004. http://www.food.gov.uk/multimedia/pdfs/fishreport2004full.pdf

22 Food Standards Agency. Oily Fish Advice: Your questions answered. Food Standards Agency,Aberdeen, 2004. http://www.food.gov.uk/multimedia/faq/oilyfishfaq

23 Department of Health. Committee on the Medical Aspects of Food Policy (COMA) Report onDietary Reference Values for Food Energy and Nutrients for the United Kingdom. HMSO,London 1991.

24 Scottish Executive. An Action Plan for Improving Oral Health and Modernising NHS DentalServices in Scotland. Scottish Executive, Edinburgh, 2005.http://www.scotland.gov.uk/Resource/Doc/37428/0012526.pdf

25 Scottish Executive. Let’s Make Scotland More Active: A strategy for physical activity, physicalactivity task force. Scottish Executive 2003. http://www.scotland.gov.uk/library5/culture/lmsa-00.asp

26 Department of Health. Committee on the Medical Aspects of Food Policy (COMA) Report onWeaning and the Weaning Diet. HMSO, London, 1994.

27 Department of Health. Committee on the Medical Aspects of Food Policy (COMA) Report onNutrition and Bone Health. HMSO, London, 1998.

28 Davies PSW, Bates CJ, Cole TJ, et al. Vitamin D: seasonal and regional differences in pre-schoolchildren in Great Britain. European Journal of Clinical Nutrition 1999; 53: 195-198.

29 Pugh, G. Contemporary Issues in the Early Years. Working collaboratively for children. PaulChapman Publishing, London 2001.

30 Gregory JR, Collins DL, Davies PSW, et al. National Diet and Nutrition Survey of Children Aged1.5-4.5 years. Report of the diet and nutrition survey. HMSO, London 1995.

31 Watt RG, Dykes J, Sheiham A. Socio-economic determinants of selected dietary indicators inBritish pre-school children. Public Health Nutrition 2001; 4: 1229-1233.

32 Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitivedevelopment in children. Journal of Nutrition 2001;13(suppl.): 649S-666S.

33 Gibson SA. Iron intake and iron status of pre-school children: associations with breakfastcereals, vitamin C and meat. Public Health Nutrition 1999; 2: 521-528.

34 Scientific Advisory Committee on Nutrition. Salt and Health Report. SACN, London, 2003.www.sacn.gov.uk

35 Scottish Executive. Nutrient Specification for Manufactured Products. Scottish Executive,Edinburgh, 2004. http://www.scotland.gov.uk/library5/education/niss-05.asp

36 Food Standards Agency. Salt: How to cut down. Food Standards Agency, Aberdeen, 2005.www.food.gov.uk or go to more specifically to http://www.salt.gov.uk/cutting_down.html

37 Wrieden et al. Children’s Food Portion Sizes: Estimation of typical portion sizes for children ofdifferent ages. Report to the Food Standards Agency, 2003 (in press).

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