New parents and caregivers ask a pediatrician about nutrition in the first few years of a child’s life more than any other care-related question. Getting the right balance of nutrients is challenging because children’s nutritional needs will change as they grow – along with their food preferences, eating habits and activity levels. A child’s nutritional needs will vary based on age, size and metabolism, existing health conditions and other factors. It is important to discuss any questions or concerns about a child’s nutritional needs with a pediatrician.

Newborn infants receive all of their nutritional requirements either through breastfeeding or formula. By eating a healthy diet, a mother who breastfeeds can help to ensure her child receives proper nutrition.

Good nutrition for children older than 2 years old is essentially the same as for adults, with the exception of the amount of calories required. Good nutrition is the right balance of nutrients, which contain different amounts of calories. For instance:

• A gram of carbohydrate provides 4 calories
• A gram of protein provides 4 calories
• A gram of fat provides 9 calories

Fats, proteins and carbohydrates are broken down into smaller molecules that are then carried through the bloodstream to all the cells in the body. For example, carbohydrates are broken down into glucose, which is used by all cells and organs. Protein is broken down into amino acids, which are needed for the continuous process of muscle and tissue growth and repair, as well as for making enzymes, hormones, antibodies and more.

Obesity and poor nutrition in children have been growing concerns among health professionals in the United States for several years. About 13 percent of children between the ages of 6 and 11, and 14 percent of children aged 12 to 19, are overweight, according to the U.S. Department of Health and Human Services. These figures have tripled over the past two decades. Teenagers who are overweight have a much greater likelihood of remaining overweight or obese in adulthood.

Long-term, poor eating habits are hard to break. By encouraging good nutrition and food choices from the beginning, a child has a better chance of avoiding obesity, cardiovascular diseases and type 2 diabetes, all of which are rising among children.

Like adults, children need the right assortment of nutrients, vitamins and minerals to grow, develop and function. Nutrients include the following:

• Carbohydrates. The primary source of calories for the human body. Nutritional experts generally recommend that between 50 and 60 percent of an individual’s total daily calories come from carbohydrates, primarily complex carbohydrates. There are two different types of carbohydrates:
  
  
• • Complex carbohydrates. These starches are found in whole grain cereals and breads, rice, potatoes, pastas, fruit and vegetables. They require more time than simple carbohydrates to process and use, so they do not build up as quickly.
    
    
  • Simple carbohydrates. Also called simple sugars, these are found in large amounts in some fruits, as well as in snack foods, candy and soda. An apple is an example of a nutritious food that contains simple carbohydrates. The carbohydrates in soda, however, provide empty calories. High sugar foods that replace whole foods (such as drinking soft drinks in place of milk) can lead to nutritional deficiencies, especially in children who have higher nutritional needs for these nutrients.
    
    
• Protein. Found in meat, poultry, fish, beans, nuts, eggs and dairy products, protein is composed of amino acids. They are crucial to building and repairing most body tissues (e.g., muscles, skin, organs). It is generally recommended that about 10 to 20 percent of an individual’s daily calories come from protein.
  
  
• Fats. Also called lipids, the proper amount of fat is vital to good health. Fat is part of all cell membranes and makes up the sheathing around nerves, which is important to efficient nerve conduction. In addition, fat absorbs and carries vitamins A, D, E and K, and affects cholesterol levels. It is recommended that no more than 35 percent of the daily dietary calories of an older child, adolescent or adult come from fat. Infants and younger children (under the age of 2 years) require additional fat intake for the production and development of brain and other nerve cells. Parents and caregivers should be aware of the types of fats that affect a child’s health:
  
  
• • Saturated fats. These fats are solid at room temperature. They come from animal products, such as butter, cheese, whole milk, ice cream and meat. Too much saturated fat can lead to high cholesterol and heart disease.
    
    
  • Unsaturated fats. These fats are liquid at room temperature. They come from vegetable oils, nuts and fish. Unsaturated fat does not raise cholesterol levels in the blood and may reduce them. Unsaturated fat can be monounsaturated or polyunsaturated (found in canola, flaxseed, peanut and olive oils). Omega 3 fatty acids are a type of polyunsaturated fat that research has found to be especially important to childhood development. The most common source for omega 3 (fish oil) also carries a risk of mercury toxicity, but it can be found in oils (such as canola and flaxseed oil) as well.
    
    
  • Trans fats. These fats are created from unsaturated fats that have been processed (hydrogenated) to make them solid at room temperature, such as in stick margarine. They may also be found naturally in similar products as saturated fats. Excess consumption of trans fats can lead to high cholesterol and heart disease.
    
    
• Fiber. A filling nutrient that helps move food through the digestive tract and prevents constipation. It may also reduce LDL cholesterol (bad cholesterol) levels in the blood and reduce the risk of diabetes and heart disease. Grains, fruits, vegetables and cereals are good sources of fiber.

Vitamins are also essential to good nutrition. Important vitamins include vitamin A, C and D. Vitamin A is important to eyesight and skin health and can be found in orange vegetables (e.g., carrots, squash) and dark green, leafy vegetables. Vitamin C, found in many fruits and some vegetables, is important for healthy teeth and gums as well as helping the body to heal wounds and fight infections. Vitamin D helps the body absorb calcium. Most vitamin D is provided by skin exposure to natural sunlight, but many dairy products are now enriched with it, as well.

Calcium is important for building healthy bones and teeth. Insufficient amounts of calcium can cause rickets (a skeletal disease), low bone density and an increased risk of fractures. Calcium is found in milk and other dairy products (e.g., yogurt, cheese). Lactose-free and low-lactose varieties of many of these products are available for children with lactose intolerance. Many other foods (e.g., orange juice, cereals) are also fortified with calcium.