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
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
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.
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
nutritional guidance for early years
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).
nutritional guidance for early years
nutritional guidance for early years
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.
9
10
nutritional guidance for early years
Gro
up1:
Bre
ad,O
ther
Cer
eals
and
Po
tato
es
All
typ
eso
fb
read
s,o
ther
cere
als
(bre
akfa
stce
real
,o
ats/
oat
cake
s,ri
ce,p
asta
,no
od
les,
cous
cous
,mai
zem
eal),
po
tato
and
star
chy
roo
tcr
op
s(e
.g.s
wee
tp
ota
to,
yam
),g
reen
pla
ntai
ns
Bre
ad
Gui
dan
cefo
rC
hild
ren
aged
1-5
year
s
Eve
rym
eala
ndm
ost
snac
kssh
oul
dco
ntai
na
po
rtio
no
rp
ort
ions
of
foo
dfr
om
this
gro
up.
Ear
lyin
tro
duc
tion
tow
hole
gra
ince
real
foo
ds
help
sch
ildre
nto
acce
pt
thes
eas
are
gul
arp
art
of
thei
rd
iet.
Fib
re-e
nric
hed
cere
als
(i.e.
bre
akfa
stce
real
sw
ithad
ded
bra
n)sh
oul
dno
tb
eo
ffer
edto
child
ren
und
er2
year
s.
Ava
riety
ofbr
eads
:who
legr
ain/
who
lem
eal,
brow
n,w
hite
,bre
ad-b
ased
snac
ks(e
.g.y
east
-typ
ebu
ns,
scon
es)s
houl
dbe
avai
labl
eda
ilyas
part
ofa
mea
lan
d/or
snac
kfo
ral
lchi
ldre
n.C
rust
ybr
ead,
quar
ters
ofbr
ead
rolls
and
buns
are
popu
lar
and
can
beof
fere
dat
snac
kor
mea
ltim
es.
As
part
ofa
mea
l,br
ead
(incl
udin
gna
an,p
itta
and
crus
tybr
ead)
can
bepr
ovid
edin
ava
riety
offo
rms.
Why
?
Sta
rchy
foo
ds
pro
vid
ees
sent
iale
nerg
yfo
rch
ildre
nan
dar
ean
imp
ort
ant
sour
ceo
fm
any
vita
min
s,m
iner
als
and
fibre
.Enc
our
age
child
ren
toea
tth
ese
foo
ds
tosa
tisfy
thei
rap
pet
ites.
Who
leg
rain
/who
lem
ealb
read
,who
leg
rain
cere
als
(e.g
.whe
atb
iscu
its,m
iniw
heat
s,p
orr
idg
e),p
asta
and
bro
wn
rice
,as
wel
las
the
whi
teva
riet
ies,
sho
uld
be
off
ered
toen
cour
age
child
ren
toen
joy
thes
eas
par
to
fa
vari
edd
iet.
Youn
gch
ildre
nha
vesm
alls
tom
achs
and
too
man
yfo
od
sw
ithad
ded
fibre
such
asfib
re-
enri
ched
(bra
n-ty
pe)
bre
akfa
stce
real
s(e
.g.
All-
Bra
n,B
ranf
lake
s,ra
wb
ran)
can
rep
lace
ener
gy-
rich
foo
ds
need
edfo
rg
row
than
din
terf
ere
with
the
abso
rptio
no
fes
sent
ial
min
eral
ssu
chas
calc
ium
and
iron.
Bre
adp
rovi
des
for
the
vary
ing
app
etite
san
den
ergy
req
uire
men
tsof
youn
gch
ildre
n.
Thes
ep
rovi
de
varie
tyan
dm
ake
the
die
tm
ore
inte
rest
ing.
Me
nu
Pla
nn
ing
by
Fo
od
Gro
up
nutritional guidance for early years
11
Gro
up1:
Bre
ad,O
ther
Cer
eals
and
Po
tato
es
Bre
akfa
stce
real
s
Pot
atoe
s,sw
eet
pota
toes
,yam
s
Gui
dan
cefo
rC
hild
ren
aged
1-5
year
s
Bre
akfa
stce
real
sm
ayb
eof
fere
dat
bre
akfa
stor
snac
ktim
e.A
varie
tyof
low
-sug
arb
reak
fast
cere
als,
e.g.
whe
atb
iscu
its,
por
ridge
,co
rnfla
kes,
rice
snap
s,un
swee
tene
dp
uffe
dw
heat
,sh
ould
be
avai
lab
le.
Thes
eb
reak
fast
cere
als
are
low
inad
ded
suga
rsa
(mos
tof
thes
ep
rod
ucts
cont
ain
less
than
15%
add
edsu
gars
,ai.e
.le
ssth
an15
gp
er10
0g).
Ther
ear
ep
lent
yof
bre
akfa
stce
real
sw
itha
low
add
edsu
gara
cont
ent
toch
oose
from
.
Hig
hly
suga
red
cere
als
and
cere
alb
ars
shou
ldno
tb
eof
fere
d(e
.g.
choc
olat
e-co
ated
cere
als,
fros
ted
flake
s,ho
ney-
coat
edce
real
s,ce
real
sw
ithsw
eet
stic
kyb
its).
Man
yof
thes
eha
vea
high
add
edsu
gara
cont
ent
ofm
ore
than
15%
(mor
eth
an15
gp
er10
0gof
pro
duc
t).Lo
w-s
alt
varie
ties
are
also
som
etim
esav
aila
ble
.
Fres
hco
oked
pot
atoe
ssh
ould
be
serv
edre
gula
rlyin
diff
eren
tw
ays:
mas
hed
,b
oile
d,
oven
bak
edor
asp
otat
ow
edge
sor
roas
tp
otat
oes
with
alig
htco
atin
gof
oliv
e,su
nflo
wer
orra
pes
eed
oil.
The
follo
win
ghi
gh-f
atp
roce
ssed
pot
ato
pro
duc
tssh
ould
bese
rved
am
axim
umof
once
ina
full
5-da
ym
enu:
chip
s,sm
iley
face
san
dot
her
shap
edp
rod
ucts
,p
roce
ssed
croq
uett
esan
dw
affle
s.
All
pro
cess
edp
otat
op
rod
ucts
shou
ldb
eov
enb
aked
rath
erth
anfr
ied
.
Why
?
Bre
akfa
stce
real
sar
ea
pop
ular
food
with
youn
gch
ildre
n;th
eyp
rovi
de
ener
gy,
man
yvi
tam
ins,
min
eral
san
dfib
re.
Man
yva
rietie
sar
efo
rtifi
edw
ithiro
n,fo
late
and
othe
rnu
trie
nts,
pro
vid
ing
anim
por
tant
sour
ceof
thes
ein
the
die
t.In
add
ition
,as
they
are
usua
llyea
ten
with
milk
,th
isp
rovi
des
furt
her
nutr
ient
s,su
chas
calc
ium
,p
hosp
horu
s,p
rote
in,
etc.
Bre
akfa
stce
real
sw
itha
high
pro
por
tion
ofad
ded
suga
rsa
pro
vid
ea
poo
rb
alan
ceof
ener
gyfo
ryo
ung
child
ren.
Too
muc
had
ded
suga
ra
lead
sto
den
tald
ecay
and
obes
ity.
Cho
ose
cere
als
that
are
low
erin
add
edsu
gars
aan
d,
whe
reav
aila
ble
,lo
win
salt.
Fres
hco
oked
pot
atoe
sse
rved
ind
iffer
ent
way
sp
rovi
de
ava
riety
ofte
xtur
es.
They
are
anex
celle
nt,
high
-qua
lity
sour
ceof
ener
gyan
dnu
trie
nts
for
child
ren.
They
are
rich
inth
eB
vita
min
san
dan
imp
orta
ntso
urce
ofvi
tam
inC
.
Man
yof
the
high
-fat
pot
ato
pro
duc
tsco
ntai
np
oor
qua
lity
fat
(hyd
roge
nate
dfa
ts)a
ndar
eal
sohi
ghin
salt.
Ifea
ten
freq
uent
ly,
they
can
lead
toan
imb
alan
cein
ener
gyan
dfa
tin
take
.
Me
nu
Pla
nn
ing
by
Fo
od
Gro
up
12
nutritional guidance for early years
Gro
up1:
Bre
ad,O
ther
Cer
eals
and
Po
tato
es
Ric
e,p
asta
,no
odle
s,co
usco
us
Gui
dan
cefo
rC
hild
ren
aged
1-5
year
s
Thes
efo
ods
are
pop
ular
with
youn
gch
ildre
nan
dsh
ould
be
pro
vid
edre
gula
rlyas
alte
rnat
ives
tob
read
and
/or
pot
atoe
s.W
hole
grai
nva
rietie
sar
esu
itab
lefo
ral
lchi
ldre
n.Th
eym
ayb
een
joye
das
par
tof
hot
orco
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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.
nutritional guidance for early years
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
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
Day 5
Bre
akfa
st
2tb
sp
ure,
unsw
eete
ned
oran
geju
ice
dilu
ted
with
wat
era
11 /2-
2tb
sb
aked
bea
nsse
rved
with
ato
aste
dm
uffin
with
spre
ad
Mid
-mo
rnin
gsn
ack
1sm
allg
lass
ofm
ilk
1 /2-
1cr
ump
etw
ithsp
read
1 /2-
1fr
esh
pea
ch
Lunc
h
1-11 /
2w
hole
mea
lrol
lsw
ithsp
read
and
fille
dw
ith1-
2th
insl
ices
ofha
mb,
1 /2
asl
iced
tom
ato,
carr
otst
icks
(1b
aby
carr
ot)
app
lesp
onge
pud
din
g(2
-3tb
s)
Mid
-aft
erno
on
snac
k
1sm
allg
lass
ofm
ilk/w
ater
1 /2-
2sl
ices
ofp
inea
pp
lein
juic
ese
rved
with
1-2
tbs
ofp
lain
yogh
urt
Tea
1 /2-
1gr
illed
salm
onst
eak,
bas
ted
with
oliv
eoi
land
serv
edw
ith2
or3
new
pot
atoe
san
dsm
allp
ortio
ngr
een
bea
ns
1sm
allc
arto
nfr
uit
from
age
frai
sse
rved
with
3or
4st
raw
ber
ries
62
tbs
pur
e,un
swee
tene
dor
ange
juic
ed
ilute
dw
ithw
ater
a
7-10
tbs
puf
fed
whe
atse
rved
with
milk
1sm
all/m
ediu
msl
ice
toas
ted
whi
teb
read
with
spre
adan
dja
m
1sm
allg
lass
ofm
ilk
finge
rfo
odse
lect
ion
incl
udin
g:6
slic
edgr
apes
(6gr
apes
),1 /
3sm
allb
anan
a,m
elon
(3ch
unks
)
lean
bee
fst
ewb
(1 /2
mug
)se
rved
with
2or
3b
oile
dp
otat
oes
boi
led
turn
ipan
dca
rrot
(1sm
all)
frui
tcr
umb
le(2
-3tb
s)an
dcu
star
d(3
-4tb
s)
1gl
ass
ofw
ater
1m
inib
lueb
erry
muf
fin
app
lesl
ices
(1 /2
smal
l/med
ium
app
le)
1m
ediu
m/la
rge
slic
eof
ciab
atta
fille
dw
ith3-
4tb
sgr
ated
ched
dar
chee
sean
d3
slic
esof
tom
ato
1 /2-
1ca
rton
frui
tyo
ghur
tw
ith1 /
2p
ear
inju
ice
72
tbs
pur
e,un
swee
tene
dor
ange
juic
ed
ilute
dw
ithw
ater
a
por
ridge
(1 /3-
1 /2
mug
)mad
ew
ithm
ilkse
rved
with
milk
1 /2
slic
eto
ast
with
spre
ad
1sm
allg
lass
ofm
ilk
1m
inip
lain
scon
e(o
r1 /
2
scon
e)w
ithsp
read
1ta
nger
ine
1m
ini/s
mal
lpitt
ab
read
fille
dw
ithtu
nab
and
1-2
dsp
swee
tcor
nm
ixed
with
1-2
tbs
pla
inyo
ghur
tse
rved
with
2-3
slic
edch
erry
tom
atoe
s
milk
jelly
(2-4
tbs)
top
ped
with
man
dar
inor
ange
s(2
tbs)
1sm
allg
lass
ofm
ilk
finge
rfo
odse
lect
ion
incl
udin
g:ca
rrot
stic
ks(1
smal
l),cu
cum
ber
(1cm
pie
cech
opp
ed)a
nd2-
3sl
iced
cher
ryto
mat
oes
larg
ecr
acke
rse
rved
with
2tb
sp
lain
yogh
urt
asd
ip
span
ish
omel
ette
c(1
egg)
and
1sm
allb
aked
pot
ato
app
lep
ie(1
-2tb
s)w
ith1
scoo
pof
vani
llaic
ecr
eam
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
nutritional guidance for early years
31
Day 8
Bre
akfa
st
2tb
sp
ure,
unsw
eete
ned
oran
geju
ice
dilu
ted
with
wat
era
1sm
allg
lass
milk
1sm
alls
lice
ofto
aste
dw
hole
mea
lbre
adw
ithsp
read
and
top
ped
with
1ra
sher
ofgr
illed
bac
onan
d3
or4
slic
esof
tom
ato
Mid
-mo
rnin
gsn
ack
1sm
allg
lass
ofm
ilk
1sm
all/m
ediu
mb
anan
a
Lunc
h
2tb
sp
ure,
unsw
eete
ned
oran
geju
ice
dilu
ted
with
wat
erc
1-2
slic
esof
crus
tyb
read
with
spre
adan
dto
pp
edw
ith2
cann
edsa
rdin
esb
(mas
hed
)an
d3
slic
esof
tom
ato
chop
ped
1ca
rton
offr
uit
yogh
urt
with
6ch
opp
edgr
apes
Mid
-aft
erno
on
snac
k
1sm
allg
lass
ofm
ilk
1m
ini/s
mal
lSco
tch
pan
cake
with
spre
ad
3or
4st
raw
ber
ries
Tea
lent
ilso
up(1 /
2-3 /
4m
ug)
1sm
alls
lice
who
lem
eal
bre
adw
ithsp
read
,to
pp
edw
ith1-
2th
insl
ices
ofco
ldro
ast
turk
eyb,
lett
uce,
3sl
ices
ofto
mat
oan
d1-
2ts
pcr
anb
erry
sauc
e
92
tbs
pur
e,un
swee
tene
dor
ange
juic
ed
ilute
dw
ithw
ater
a
por
ridge
(1 /3-
1 /2
cup
)mad
ean
dse
rved
with
milk
1sm
alls
lice
ofto
aste
dw
hite
bre
adw
ithsp
read
1sm
allg
lass
ofm
ilk
1m
ini/m
ediu
mch
eese
scon
ew
ithsp
read
serv
edw
ith3
slic
edch
erry
tom
atoe
s
mild
chic
ken
korm
ab(1 /
3-1 /
2
mug
)ser
ved
with
2-21 /
2tb
sb
oile
dric
ean
da
slic
eof
naan
bre
ad(1 /
6-1 /
3la
rge
naan
)
2tb
sfr
uit
yogh
urt
1sm
allg
lass
ofm
ilk
1sm
allb
anan
aor
finge
rfo
odse
lect
ion:
chop
ped
ban
ana,
1 /2
app
lean
d1
oatc
ake
1-2
min
iwho
lem
ealr
olls
with
spre
ad,
fille
dw
ith1
slic
edha
rd-b
oile
deg
g,c
2sl
ices
ofto
mat
oan
dm
usta
rdan
dcr
ess
spon
gep
udd
ing
(2-3
tbs)
and
frui
tco
ckta
il(2
tbs)
102
tbs
pur
e,un
swee
tene
dor
ange
juic
ed
ilute
dw
ithw
ater
a
1sc
ram
ble
deg
gcse
rved
ona
smal
l/med
ium
slic
eof
toas
tw
ithsp
read
1gl
ass
ofw
ater
1-2
dsp
ofp
lain
from
age
frai
s
1fr
esh
plu
m
vege
tab
lela
sagn
e(1 /
2-1
mug
)ser
ved
with
1sl
ice
ofga
rlic
bre
ad
1 /3-
1 /2
mug
rice
pud
din
gto
pp
edw
ith1
heap
edtb
sof
pur
eed
app
les
1sm
allg
lass
ofm
ilk
1or
2cr
acke
rsw
ithch
edd
arch
eese
(11 /
2tb
sgr
ated
or1 /
2-1
mat
chb
oxsi
zep
iece
)an
dap
ple
(1 /2
med
ium
)
min
estr
one
soup
(1 /2-
3 /4
mug
)
1-2
slic
esof
toas
ted
whi
teb
read
,w
ithsp
read
and
top
ped
with
1-11 /
2sl
ices
ham
ban
da
pin
eap
ple
ring
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
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
itca
nb
ese
rved
und
ilute
d,
orw
itha
grea
ter
pro
por
tion
ofw
ater
toju
ice
ifa
long
er,
mor
eth
irst-
que
nchi
ngd
rink
isp
refe
rred
.b
For
vege
taria
nop
tions
for
mea
t,fis
han
dch
icke
nth
efo
llow
ing
can
be
used
assu
bst
itute
s:fo
rb
eef
stew
,b
eef
coul
db
esu
bst
itute
dw
ithch
ickp
eas
orki
dne
yb
eans
;in
bol
ogne
se,
mea
tco
uld
be
sub
stitu
ted
with
soya
min
ce;
chee
se,
hum
mus
oreg
gco
uld
rep
lace
tuna
;ch
icke
nco
uld
be
sub
stitu
ted
with
lent
ilsor
chic
kpea
s.O
ther
suita
ble
sub
stitu
tes
are
vegg
iesa
usag
es,
quo
rn,
pea
nut
but
ter,
bak
edb
eans
,ch
eese
and
bea
nb
urge
rs.
cW
here
fres
heg
gsar
eno
tus
edto
avoi
dth
eris
kof
Sal
mon
ella
,sl
iced
hard
-boi
led
eggs
and
scra
mb
led
eggs
can
be
sub
stitu
ted
with
drie
dp
owd
ered
egg.
dTh
esp
read
used
ism
onou
nsat
urat
edor
pol
yuns
atur
ated
–th
isap
plie
sto
allr
efer
ence
sto
‘sp
read
’th
roug
hout
the
doc
umen
t.
32
nutritional guidance for early years
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.
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
nutritional guidance for early years
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.
nutritional guidance for early years
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.
nutritional guidance for early years
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.
nutritional guidance for early years
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:
nutritional guidance for early years
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.
nutritional guidance for early years
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
nutritional guidance for early years
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.
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
nutritional guidance for early years
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
nutritional guidance for early years
nutritional guidance for early years
51
Day 1
Bre
akfa
st
pur
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swee
tene
dor
ange
juic
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ted
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wat
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(110
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rved
with
milk
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l)
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who
lem
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read
(sm
alls
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25g)
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ad(5
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Mid
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(100
ml)
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cake
,(2
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Lunc
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clud
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with
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cust
ard
(60g
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(50g
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Mid
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(40g
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(100
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min
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(55g
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50g)
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(5g)
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(80g
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(40g
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(100
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ake
(30g
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(80g
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drie
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(15g
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rais
ins
(15g
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milk
(100
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(60g
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(150
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(20g
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app
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a
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ithm
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and
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(20g
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lslic
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ted
whi
teb
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(25g
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spre
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milk
(100
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52
nutritional guidance for early years
Day 5
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pur
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swee
tene
dor
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juic
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wat
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bak
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(5g)
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-mo
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milk
(100
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(20g
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(50g
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who
lem
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50g)
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(30g
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(60g
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(100
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(30g
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(30g
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bee
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(90g
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atoe
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led
(30g
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s(3
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d(4
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er
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5g)
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le(3
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ndto
mat
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(50g
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frui
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7p
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milk
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toas
t(1
5g)
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(100
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spre
ad(1
0g)
tang
erin
e(3
0g)
pitt
ab
read
(35g
)fill
edw
ithtu
nab
(45g
)and
swee
tcor
n(2
0g)w
ithp
lain
yogh
urt
(20g
)se
rved
with
tom
atoe
s(2
0g)
milk
jelly
(90g
)with
man
dar
inor
ange
s(5
0g)
milk
(100
ml)
chop
ped
carr
ots
(30g
)and
cucu
mb
er(3
0g)s
liced
cher
ryto
mat
oes
(30g
)
Sp
anis
hom
elet
te(8
0g)a
ndb
aked
pot
atoe
s(8
0g)
app
lep
ie(6
0g)w
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
)
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
nutritional guidance for early years
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
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(40g
)
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ay
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ater
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ever
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ted
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with
agr
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erto
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ore
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ney
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utth
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ocum
ent.
nutritional guidance for early years
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
nutritional guidance for early years
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.
nutritional guidance for early years
59
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.
60
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61
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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