Children need their own dietary guidelines, say experts

When it comes to dietary needs, children are not miniature adults. A growing recognition of these age differences in dietary needs is why many health professionals and nutrition-related organizations recommend that the slated Year 2000 revisions of the U.S. Dietary Guidelines for Americans include age-specific guidelines for children, as well as for adults at the other end of the age spectrum.

The influential guidelines are the cornerstone of federal nutrition programs including Food Stamps and National School Lunches and are used widely by health professionals and the general public.

An article in the October issue of the American Society for Nutritional Sciences’ Journal of Nutrition reviews key recommendations on dietary guidance targeting children from a dozen organizations, panels, workshops, and surveys during the past six years. Nutrition researchers Susan M. Groziak and Gregory D. Miller, of the National Diary Council, say the conclusions are virtually identical. All support the development of separate guidelines to be based on sound scientific evidence of safety and efficacy for children, not from the results of research with adults, which are then extrapolated to children.

"that’s the way the u.s. department of agriculture and the department of health and human services (authors of the guidelines) appear to be headed," says Dr. Miller. "they’re following the growing scientific evidence that diets that help maintain health and prevent disease in a full-grown adult may not be adequate to achieve a child’s genetic potential for growth and development."

Revised every five years to reflect current nutrition knowledge, the federal dietary guidelines remained one size fits all, lumping nutritional advice for two-year-olds with that for adults of all ages, until 1995. The guidelines now in effect were the first to suggest very young children had different dietary needs.

Rather than insist that children should consume a low fat diet beginning at age two, as earlier guidelines had advised, the 1995 guidelines recommend that such changes be made gradually between the ages of two and five; that all major changes in a child’s diet be accompanied by monitoring of growth by a health professional at regular intervals; and that children and teenagers not drink alcohol at all. The 1995 Dietary Guidelines Advisory Committee also strongly recommended the development of dietary guidelines specifically for children, and scientists in the Life Sciences Research Office are now reviewing the scientific literature on childhood nutrition under contract with the U.S. Department of Agriculture and the Department of Health and Human Services.

Groziak and Miller’s review article in the Journal of Nutrition draws from position statements of the National Cholesterol Education Program, American Academy Pediatrics Committee on Nutrition and a later Commission on Nutrition, Joint Working Group of the Canadian Paediatric Society and Health Canada, American Dietetic Association, American Heart Association; meetings and workshops held by the American Health Foundation and Kellogg’s, American Society for Nutritional Sciences (formerly the American Institute of Nutrition), American College of Nutrition, American Society for Nutritional Sciences; and surveys by the American Dietetic Association, International Food Information Council, and the President’s Council on Physical Fitness and Sports, and the National Dairy Council.

Several themes appeared over and over throughout the six years and the dozen organizations or studies covered in the review:

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The need for young children to move gradually, not suddenly, to a restricted fat diet. Position statements from these groups in the early 1990s appear to have been instrumental in the change of the 1995 guidelines to recommend that early childhood be considered a transition period during which the fat content should gradually decrease to recommended levels.

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a call for guidelines to be based on research determining the health benefits of applying these guidelines to children, recognizing that a lack of evidence of harm does not mean that such dietary recommendations are safe. As early as 1992, the American Academy of Pediatrics Committee on Nutrition expressed caution that applying the standard recommendations that adults receive no more than 30 percent of their energy from fat might be too restrictive for children who had not yet achieved full linear growth. Such data are lacking, say organizations like the American Society for Nutritional Sciences.

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a concern that restrictive guidelines are too often misapplied by parents eager to do what’s right for their children. "Health professionals must recognize that there is a low level of nutrition knowledge within the general public and that nutrition misinformation abounds," says Dr. Miller. That means guidelines need to be "carefully constructed to avoid adversely affecting nutritionally vulnerable age segments such as children and older adults."

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the need for messages concerning dietary guidance to be positive, emphasizing a healthy diet rather than labeling certain foods as "bad" or creating fear about eating specific foods or categories of foods. To do otherwise may result in potential harmful effects caused by dietary restrictions in children. For example, a workshop last year on the role of dietary fat in child nutrition and development held by the American Society for Nutritional Sciences expressed concern that lower fat diets that eliminated or severely limited meat and milk might not supply adequate energy or nutrients such as iron, zinc and calcium to support normal growth and development during childhood. Unfortunately, says Dr. Miller, that appears to be the message that’s going out. The 1995 Food, Physical, Activity & Fun: What Kids Think Survey by Gallup found that more than four out of five (81 percent) children between the ages of 9 and 15 thought eating healthy meant avoiding all high fat foods.

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the need for messages to the children themselves to be positive, food-based rather than nutrient-based for understanding, and to incorporate messages on physical activity. "there should be a focus on a nutritious diet as part of a healthy lifestyle rather than a focus on dietary restrictions."