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N for Kids
 utrition
A Dietary Approach to Lifelong Health




 THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE
Parents know that the road to lifelong
                                                    W
      good health starts with healthy eating

      and plenty of exercise. Getting kids and

      families started down this path is easy

      with a little assistance. In this guide you

      will find the tools you and your family

      need to achieve many of your health

      goals: up-to-date health and nutrition

      information, advice on changing habits,

      tips to get your family started, and plenty

      of delicious recipes.




II   Nutrition for Kids   •   PCRM
Weigh ing In
              on Health
 People who maintain a healthy weight throughout life
 stay well and live longer than those who are overweight.
 The lifestyle habits that help keep us slim—exercise and a
 healthy diet—also cut our risk of diabetes, heart disease,
 high blood pressure, and some cancers.

    The prevalence of obesity among         spectively). One-fourth to one-third of
 our nation’s youth has more than dou-      dieting adolescents practice unhealthy
 bled in the past 20 years, with close to   or even dangerous diets.3 In a study of
 5 million youths aged 6 to 17 seriously    5- to 12-year-olds, 45 percent of the
 overweight or obese. The concerns          girls and 20 percent of the boys re-
 caused by overweight are more than         ported having been on a diet.4 Cutting
 a cosmetic issue. Childhood obesity        calories dramatically is often effective
 leads to a variety of health problems,     at lowering weight for the short term,
 such as type 2 diabetes, high blood        but this usually results in overeating
 pressure, and heart disease.1 The Cen-     or binge eating and regaining of any
 ters for Disease Control and Preven-       lost weight. High-protein, low-carbo-
 tion recently found that 60 percent of     hydrate, and very low calorie diets are
 overweight 5- to 10-year-olds already      not safe for children or teens.
 have at least one risk factor for heart       Instead, children (and adults)
 disease, such as raised blood pressure     merely need to switch to healthy foods.
 or insulin levels.2                        When the diet is built from fruits,
    Many adolescent boys and girls in       vegetables, grains, and legumes, weight
 the United States are currently trying     management is much easier, and putting
 to lose weight (36 and 44 percent, re-     limits on calories is unnecessary. For



                                                     Nutrition for Kids   •   PCRM   1
Food                                     Calories       Fat (g)      Fiber (g)

    Veggie Burger                               264            0.5              8

    Hamburger                                   444            21               2

    Homemade Bean Burrito                       255             2               12

    Fast-food Chili-Cheese Burrito              390            18               4




example, a veggie burger has 0.5 grams       calories). It’s easy to make the switch
of fat, saving 20 grams of fat and 180       and well worth the time.
calories (compared with a hamburger              The bottom line is that it is always
at 21 grams of fat and 444 calories). A      the right time to adopt a healthful diet.
homemade bean burrito with lettuce,          It is important to help all children, re-
tomato, and salsa has 2 grams of fat,        gardless of body size, choose a healthy
saving 16 grams of fat and 135 calories      eating style and incorporate fun physi-
(compared with a fast food chili cheese      cal activity into their lives now and in
burrito with 18 grams of fat and 390         the future.


    Food Choices for Achieving and
     Maintaining a Healthy Weight
   Choosing a plant-based eating style       to be effective in weight loss.7
is a simple way to achieve or maintain          Dr. Benjamin Spock, pediatrician,
a healthy weight because such dietary        medical researcher, and teacher, advised
patterns require no calorie counting         in his book, Dr. Spock’s Baby and Child
and contain the nutrients a fit body         Care, that weight-loss programs for
needs. Vegetarians have been shown to        children should be based on changing
be leaner than their meat-eating peers       the types of foods children eat rather
in a number of scientific studies, 5,6 and   than the amount of food they eat. He
vegetarian diets have also been shown        encouraged shifting the entire family


2   Nutrition for Kids   •   PCRM
their food intake because of concerns
                                            about health, body size, or personal be-
                                            liefs, they focus too narrowly on just a
                                            small number of foods. Exploring the
                                            broad range of healthful foods now
                                            available makes a menu change fun,
                                            nutritious, and sustainable.
                                            •	 Choose low-fat, healthful options
away from oily fried foods, meats,          whenever possible. Choosing lower fat
and dairy products and toward low-          recipes and foods and eating a variety
fat, plant-based foods­ grains, pasta,
                        :                   of colors are good ways to ensure that
vegetables, legumes, and fruit. When        your child’s diet is a healthy one. For
this is done, he stated, “weight loss       example, oven-roasted potatoes should
typically occurs without anyone going       be chosen over French fries, pasta with
hungry.” 6,8 This is the key to lifelong    marinara sauce is a better option than
weight maintenance. The scientific          spaghetti with meatballs, and fruit sor-
evidence is clear: The closer a family      bet is just as refreshing but much more
gets to a pure vegetarian diet, the         healthful than ice cream. The net effect
healthier and leaner they’ll be.            (not easily detected) is usually a reduc-
Here are some ideas for making the          tion in the number of calories and fat
switch:                                     consumed in any given portion of food.
•	 Identify three or four vegetarian        Plus, the introduction of new foods ad-
recipes your family already enjoys. Ex-     justs the taste buds and develops an ap-
amples include bean burritos, pasta         preciation for good, wholesome food.
with marinara sauce, vegetable stir-
                                            •	 It’s best to avoid foods and beverages
fries, and vegetable soup. Next, think of
three or four more frequently prepared      that have lots of calories but few or no
meals that can be easily adapted. For       nutrients, such as candy, soda, punch,
example, chili can be made vegetarian       cookies, and fried snack foods. Fatty
with beans, and other favorites, such       condiments like creamy salad dress-
as sloppy joes and tacos, can be made       ings, mayonnaise, butter, and marga-
with texturized vegetable protein.          rine are best left off the plate. Instead
•	 Experiment and broaden food op-          of centering meals around fatty meats
tions. Try new foods, recipes, and places   and cheese, meals should be built from
to eat to keep it interesting and enjoy-    the New Four Food Groups: healthy
able. Sometimes, when people change         grains, legumes, fruit, and vegetables.


                                                     Nutrition for Kids   •   PCRM   3
The New Four                            •   One serving of vegetables equals
                                               1/2 cup cooked or 1 cup raw (unless
       Food Groups                             an amount is specified in the table on
       Plan menus using the New Four           page 6).
    Food Groups: whole grains, vegeta-
    bles, legumes, and fruit. Nutritious       Legumes, Nuts, Seeds,
    diets built from these food groups           and Non-Dairy Milks
    help children improve their overall           Legumes, nuts, seeds, and non-
    well-being, maintain a healthy weight,     dairy milks are all good sources of
    and reduce their risk of illnesses that    protein, iron, calcium, zinc, and B
    can arrive later in life. See suggested    vitamins. Legumes are great sources
    servings in the daily meal planning        of fiber.
    table on page 6.
                                               •	 Legumes include beans, such as
                                               pinto, navy, kidney, and garbanzo;
         Whole Grains
                                               lentils, black-eyed or split peas; and
      Grains are rich in fiber and other       products made from soybeans, such as
    complex carbohydrates, as well as          tofu, veggie burgers, soy “hot dogs” or
    protein, B vitamins, and zinc.             sandwich slices, and tempeh, a hearty
    •	 Whole grains include breads, hot        fermented soy product that can be
    and cold cereals, pasta, cooked grains     used in place of meat in many recipes.
    such as rice and barley, and crackers.     •	 One serving of legumes equals 1/2
    •	 One serving equals 1/2 cup of pas-      cup of beans, tofu, or other item (un-
    ta, grains, or cooked cereal; 3/4 to 1     less an amount is specified).
    cup of ready-to-eat cereal; 1/2 bun or     •	 Non-dairy milks include breast
    bagel; or 1 slice of bread.                milk and soy formula for infants and
                                               toddlers, and rice-, soy-, and other
           Vegetables                          vegetable-based milks for children
       Vegetables are packed with vitamin      at least one year of age. Choose for-
    C, beta-carotene, riboflavin, iron, cal-   tified soymilk, whenever possible, or
    cium, fiber, and other nutrients.          use other fortified, plant-based milks
    •	 “Dark green vegetables” include         such as rice, almond, or oat milk.
    broccoli, kale, spinach, and collards,     •	 One serving of non-dairy milk
    turnip greens, mustard greens, beet        equals one cup.
    greens, bok choy, and Swiss chard.         •	 Nuts include whole or chopped
    •  “Other vegetables” refers to all oth-   nuts, nut butters, whole seeds, and
    er vegetables, fresh or frozen, raw or     seed butters.
    cooked.                                    •	 One to two servings of nuts may be

4   Nutrition for Kids   •   PCRM
Sample Menus for Children and Teens

 Breakfast:	 Oatmeal with applesauce, calcium-fortified orange juice
 Lunch:	       Alphabet Soup*, whole-grain crackers, carrot sticks, banana, soymilk
 Dinner:	      Pita Pizzas*, fresh cucumber, cherry tomatoes
 Snacks:	      Peach, granola or energy bar, soymilk

 Breakfast:	 Whole-grain cereal with strawberries and soymilk
 Lunch:	       Hummus sandwich on whole-wheat bread with lettuce and
 	             tomato, apple juice, orange wedges, carrot sticks
 Dinner:	      Baked veggie nuggets, simply delicious winter squash*, roasted sweet 	
 	             potato wedges*, soymilk, fruit salad
 Snacks:	      Graham crackers, banana

 Breakfast:	 Granola topped with soy yogurt, blueberries, and almonds;
 	             calcium-fortified orange juice
 Lunch:	       Curly pasta salad*, green salad, whole-wheat bread, apple
 Dinner:	      Chili Mac*, green beans, cucumber salad
 Snacks:	      Popcorn, trail mix, strawberries

 Breakfast:	 Bagel with peanut butter and banana, calcium-fortified orange juice
 Lunch:	       Veggies in a blanket*, pretzels, apple
 Dinner:	      Bean burrito with lettuce, tomato, and guacamole; rice; baked tortilla 	
 	             chips and salsa; peach; soymilk
 Snacks:	      Hummus and crackers, strawberry smoothie*

 * See delicious recipes starting on page 14

included in a healthy diet, but they are        that are high in vitamin C—citrus
optional. One serving of nuts or nut            fruits, melons, and strawberries are all
butters equals 1 tablespoon.                    good choices.
                                                •	 Fruits include all fruits, fresh or fro-
              Fruits                            zen, raw or cooked, and fruit juices.
   Fruits are rich in fiber, vitamin C,         •	 One serving equals 1/2 cup cooked
and beta-carotene. Be sure to include           fruit, 1/2 cup fruit juice, 1/4 cup dried
at least one serving each day of fruits         fruit, or 1 piece of whole fruit.

                                                         Nutrition for Kids     •   PCRM   5
Daily Meal Planning for Children and Teens
Planning meals based on the New Four Food Groups is easy and helps ensure grow-
ing kids get the important nutrients they need. Caloric needs vary from child to child.
The following guidelines are general ones.

    1- to 4-Year-Olds     5- to 6-Year-Olds      7- to 12-Year-Olds    13- to 19-Year-Olds

                        Whole Grains, Breads, Cereals
       4 servings             6 servings             7 servings            10 servings

                                      Vegetables

    2 to 4 tbsp dark     1/4 cup dark green       1 serving dark         2 servings dark
    green vegetables          vegetables         green vegetables       green vegetables
     1/4 to 1/2 cup         1/4 to 1/2 cup       3 servings other       3 servings other
    other vegetables      other vegetables          vegetables             vegetables

                 Legumes, Nuts, Seeds, Non-Dairy Milks
                            1/2 to 1 cup            2 servings              3 servings
     1/4 to 1/2 cup           legumes                 legumes                legumes
        legumes          3 servings soymilk     3 servings soymilk        2 to 3 servings
                         or other non-dairy     or other non-dairy       soymilk or other
                                milk                    milk              non-dairy milk

                                           Fruits
      3/4 to
                              1 to 2 cups            3 servings             4 servings
    1 1/2 cups

                             Be sure to include a source of vitamin B12, such as any typical
                             children’s multivitamin or vitamin-fortified cereals or soymilk.




6   Nutrition for Kids   •   PCRM
Kid Classics                        soymilk to vanilla soy ice cream, and
                                          blend to make a smoothie. A scoop
   Being vegetarian doesn’t mean hav-
                                          of fruit sorbet—found at many of the
ing to give up classic kid fare. While
                                          large ice cream chains or at the grocery
whole, unprocessed fruits, vegetables,
                                          store—is also a refreshing treat on a
grains, and legumes should be chosen
                                          hot summer day.
first, many of the foods children enjoy
can be adapted to fit into a vegetarian   •	 Fast Food. Burger King now of-
menu. Here are some tips:                 fers a terrific veggie burger. Other
                                          food chains, such as Subway, also offer
•	 Pizza. Try ordering pizza without
                                          vegetarian sandwiches, and Taco Bell
the cheese and pile on the veggies. If
                                          makes a bean burrito (just ask them to
making pizza at home, top it off with
                                          hold the cheese).
vegetarian meatballs or veggie pep-
peroni.
                                          Keeping Kids Moving
•	 Hamburgers and Hot Dogs. Both
                                              Fitness has four dimensions: car-
come in a wide variety of veggie ver-
                                          diovascular, strength, flexibility, and
sions. You can microwave them, bake
                                          body composition. Activities that get
them, grill them, and top them with
                                          the heart pumping, such as running,
everything you traditionally enjoy, in-
                                          swimming, bicycling, aerobics, and
cluding soy cheese.
                                          playing sports or outdoor neighbor-
•	 Cold Cut Sandwiches. Even the          hood games, improve cardiovascular
cold cut now has a non-meat alterna-      fitness. Strength-training activities,
tive. Try a slice of veggie ham, veggie   such as weightlifting, push-ups, and
turkey, or veggie salami topped with      sit-ups, as well as many daily tasks,
lettuce and tomato and a thin layer of    such as digging in the garden, lifting
mustard or vegan mayonnaise between       boxes, carpentry work, and so forth,
slices of whole-wheat bread.              improve muscular development and
•	 Chicken Nuggets and Buffalo            bone strength. Stretching, yoga, gym-
Wings. Several companies offer these      nastics, dancing, and martial arts all
traditional favorites in veggie form      promote flexibility.
(look in the frozen food section of the      A healthy body composition
supermarket). Just add ketchup or bar-    balances muscle and other lean tissue
beque sauce.                              with an appropriate amount of fat tissue
•	 Ice Cream. Soy ice cream is a ter-     for a child’s age and sex. Healthy body
rific non-dairy alternative that comes    compositions are achieved through a
in a variety of styles and flavors. For   combination of an active lifestyle and
a twist, add frozen fruit and a little    a healthy menu of grains, vegetables,


                                                   Nutrition for Kids   •   PCRM   7
Healthy Snacks
Young children have high calorie and nutrient needs but their
stomachs are small. Teenagers also often have high energy needs
combined with busy schedules. Keep delicious, healthy snack choices
on hand both at home and in the lunchbox.
Snacking on the New Four Food Groups

                   Whole Grains, Breads, Cereals
    Pita chips, pretzels, whole-grain crackers, granola, whole-grain cereal,
    popcorn, energy bars, granola bars

                                    Vegetables
    Baby carrots, celery stalks (try with peanut butter and raisins), cucum-
    ber, carrots, tomato with non-dairy dressing, salsa (try with pita chips)

            Legumes, Nuts, Seeds, Non-Dairy Milks
    Hummus (try on carrots or crackers), nut butters (put on bread or
    fruit), edamame (whole cooked soybeans), soy yogurt (sprinkle with
    granola), soymilk, rice milk, almond milk

                                      Fruits
    Fortified orange juice, whole fresh fruits, dried fruit, applesauce,
    fruit cups, frozen grapes or banana slices


legumes, and fruit.                        diet. Keep in mind that the two main
   Find ways to incorporate fun physi-     contributors to overweight are low ac-
cal activity into your family activities   tivity level and diets based on meat,
daily. Kids need to be engaged in active   dairy products, and high-calorie, low–
pursuits for at least an hour each day.    nutrient foods. The first step toward
                                           health is assessing a family’s lifestyle
     Already Over-                         by looking at eating patterns and ac-
    weight Children                        tivities to determine what changes are
  Just as with slim children, it is al-    needed to promote fitness and achieve
ways the right time to adopt a healthy     a healthy weight. The easiest and most


8   Nutrition for Kids   •   PCRM
effective method is for all mem-      etables, and fruit. Plan menus using the
   bers of the family to shift together—    New Four Food Groups (see page 4).
if possible—to a healthier lifestyle. The
same healthy habits will benefit the rest           Learning to
of the family as well as the overweight               Eat Well
child.
                                            •	 Limit the quantities of highly pro-
   Focusing on overall health is a bet-     cessed foods and sugary beverages
ter choice than embarking on a low-         (otherwise known as “empty-calorie”
calorie diet for achieving fitness and a    foods) and help children understand
healthy weight. The idea is to focus on     reasonable portion sizes. Under most
the quality of what is being eaten, not     circumstances, restricting the calorie
so much on the quantity. The healthiest     intake of children is not recommend-
diet avoids animal products completely      ed. Children continue to grow and de-
and is built from grains, legumes, veg-     velop into their early twenties, so they
                                            can’t afford to short change nutrients.
                     Healthy body           However, switching out the empty-
                                            calorie foods with healthy options en-
                     compositions           sures growing kids get everything they
                                            need—except the excess calories!
                      are achieved
                                            •	 Children and adults can benefit
                          through a         from learning to listen to their natural
                                            hunger and fullness cues, rather than
                      combination           focusing on “cleaning their plates.”
                       of an active         Help children learn to pay attention to
                                            natural internal signals to keep from
                       lifestyle and        overeating. If a child does not want to
                                            finish his or her meal now, the plate
                          a healthy         can be wrapped and saved for when the
                            menu of         child is hungry later. Promising dessert
                                            as a reward is best avoided as well, as it
                              grains,       encourages overeating and makes less
                                            healthful foods seem special.
                        vegetables,         •	 Teach children the value of good nu-
                           legumes,         trition. Parents, guardians, and teach-
                                            ers can work with children toward an
                          and fruit.        understanding that food is a fuel for
                                            health and fitness rather than a com-


                                                     Nutrition for Kids    •   PCRM   9
fort, friend, enemy, or boredom re-
                                     liever. Reading books to children
                                     that present nutrition in a fun
                                     and interesting manner is also a
                                     good educational method.
                                     •	 Get kids engaged in the food
                                     procurement and preparation process.
                                     Gardening; picking berries, apples, or
                                     other produce at you-pick farms; or vis-
                                     iting the local farmers market or fruit
                                     stand can spark an interest in healthy
                                     foods. Invite them also to participate in
                                     menu planning, as well as cooking. Even
                                     very small children can help stir cold or
                                      room temperature items, or wash pro-
                                           duce, or pour ingredients. These
                                             simple experiential lessons will
                                               often go a long way to promot-
                                               ing healthy eating habits.

                                             Fitting In Fun
                                          Physical Activities
                                     •	 Encourage children to play with
                                     other children and to do active things
                                     with family members. Most communi-
                                     ties have locally organized activity pro-
                                     grams after school, on the weekends,
                                     and during the summer. Since gym class
                                     and team sports are not every child’s cup
                                     of tea, encouraging individual interests
                                     such as ice skating, ballet dancing, or
                                     skateboarding are important, too.
                                     •	 It’s important for parents to talk
                                     with children about their activity pat-
                                     terns. Children should be active for at
                                     least 60 minutes on most days. Seden-
                                     tary activities, such as TV watching


10   Nutrition for Kids   •   PCRM
and computer time, should    stand what options should be avail-
            be limited except when       able for children.
           homework requires it. It         Here are some suggestions for im-
          is estimated that, on aver-    proving the healthfulness of foods
        age, U.S. preschoolers spend     eaten in schools:
       23 hours a week in front of
                                         •	 Pack a lunch. Bean and pasta sal-
      the television and grade-school
                                         ads, grilled tofu, burritos, and sand-
   students watch for 29 hours each
                                         wiches make great lunches and are
week. Add to this the time spent
                                         easy to pack. Last night’s leftovers are
playing video games, using the In-
                                         also a great, simple choice. Make sure
ternet, doing homework, and eating
                                         to include several healthy snacks.
dinner—and many kids spend a lot of
time sitting still.                      •	 Encourage your child to request
                                         that low-fat, vegetarian entrées be
   Encouraging children to adopt a
                                         placed on the lunch line. Demand for
healthy, vegetarian eating style and
                                         these items will encourage the food
teaching them to enjoy being active
                                         service to incorporate healthier foods
are likely the most important lessons
                                         into their menu cycle.
children can learn for their long-term
health.                                  •	 Parents can also volunteer their
                                         time. Get involved with the PTA or
   Surviving the                         directly with the food service. Work
                                         with them to help incorporate health-
 School Lunch Line
                                         ier foods. Some parents have even
   Families can also help to improve     donated recipes or planned healthy
“get healthy” opportunities for chil-    snack breaks in the classroom.
dren in schools. Many schools are
                                         See www.HealthySchoolLunches.org
under financial pressure to down-
                                         for more information.
size health and physical education
programs, so health-conscious fami-
                                          Staying Clear of
lies should support school districts
in their efforts to promote wellness
                                          the “Food Fight”
     and physical education and to          Children learn very early that what
      promote healthier lunches in       they eat is important to their parents,
      the cafeteria. School lunch pro-   and they often use this knowledge to
      grams are required to provide      their advantage. Parents may sit for
      nutritious, low-cost meals to      hours at the dinner table with their
      students; parents and teachers     children until they finish their last
      can help school officials under-   asparagus spear. Food can be used as
                                         a reward, a way to exert control, or a

                                               Nutrition for Kids    •   PCRM   11
way to rebel. Rewarding kids for good        to using non-food treats as
grades or good behavior with sweets          rewards, such as a warm con-
can set up internal conflicts about          versation, reading, going to a
food. This is especially true if the re-     movie or the park, making some-
wards are in opposition to current           thing, calling Grandma or a friend,
goals for health or body image. If not       or engaging in physical activities.
dealt with early, these “food fights”        •	 Set clear divisions of responsibil-
may extend into adult life as well.          ity. If a “food fight” develops, parents
   Finding a way to sidestep the “food       should define responsibilities around
fight” is a priority. If a child is having   foods. The parent is responsible for
trouble sticking to healthful foods, the     providing appropriate food choices.
following strategies may be helpful.         The child is responsible for choosing
•	 Stock the kitchen with healthy            what to eat among the choices offered.
foods. Having plenty of fruits, veg-         •	 Allow for healthy treats. Fresh-fruit
etables, grains, and beans on hand           smoothies, a colorful cup of berries in
and keeping unhealthful foods out of         season, or a vegetable dish prepared a
the house are simple ways to eliminate       favorite way can all be special treats
conflict over which type of food to          and prevent a family from feeling de-
prepare or eat.                              prived.
•	 Focus on food as a fuel for health.
Choosing a simple, health-giving way            Sticking with It
of eating like the one suggested in             The ease with which kids transition
these pages and explaining to children       into and stick with this healthy dietary
why it is important to eat this way will     pattern can be positively influenced by
help them to appreciate and choose           a variety of factors. Family support, in
healthful foods.                             terms of providing healthy foods and
•	 Reduce the emphasis on food in            setting a good example, as well as edu-
daily life. When people solve problems       cation about nutrition, are key. If your
by eating or congratulate themselves         children have convictions about the
with food, the importance of food has        welfare of animals or reducing the im-
gotten out of control. Finding other         pact on the environment and/or have
solutions to problems, such as talking       a clear understanding of the health
about them, writing about them in a          value of good eating habits, they will
journal, or taking a walk or a bike ride     be more likely to make the switch eas-
to figure out possible steps to take, are    ily and be able to maintain this diet,
much healthier and more productive.          not only while away from home, but
Families should become accustomed            throughout their lives.


12   Nutrition for Kids   •   PCRM
For More Information, Please visit our Web sites:

    PCRM’s Healthy Kids               PCRM’s Healthy School
      Campaign site:                   Lunch Campaign site:
   www.KidsGetHealthy.org          www.HealthySchoolLunches.org
    Our main site for general       The PCRM Marketplace Online for
   information about healthy            information on our book,
   eating and our campaigns:        Healthy Eating for Life for Children:
       www.PCRM.org                              pcrm.org.shop

             For nutrition tips and recipes for all age
                groups, visit www.NutritionMD.org




                                           References
              When children      1. Vanhalla M. Childhood weight and metabolic syn-
                                 drome in adults. Ann Med 1999;31:236-239.
          eat healthful foods    2. Centers for Disease Control and Prevention.
                                 CDC Surveillance Summaries, July 7, 2000. MMWR
          and stay physically    2000;49 (No. SS-6).
                                 3. Neumark-Stainzer D, Rock CL, Thornquist
          active, their bodies   MD, Cheskin LJ, Neuhouser ML, Barnett MJ.
                                 Weight-control behaviors among adults and ado-
                                 lescents: associations with dietary intake. Prev Med.
             find their way to   2000;30:381-391.
                                 4. Neumark-Stainzer D, Hannan PJ. Weight-related
                a healthy size   behaviors among adolescent girls and boys: results
                                 from a national survey. Arch Pediatr Adolesc Med.
               and shape in a    2000;154:569-577.
                                 5. Snowdon DA, Phillips RL. Does a vegetarian diet
             pleasurable and     reduce the occurrence of diabetes? Am J Publ Health.
                                 1985;75:507-512.

             sustainable way.    6. Melby CL, Goldflies DG, Hyner GCL, Lyle RM.
                                 Relations between vegetarian/non-vegetarian diets
                                 and blood pressure in black and white adults. Am J
                                 Publ Health. 1989;79:1283-1288.
                                 7. Ornish D, Brown SE, Scherwitz LW, Billings JH, et al.
                                 Can lifestyle changes reverse coronary heart disease?
                                 The lifestyle heart trial. Lancet. 1990;336:129-133.
                                 8. Spock B, Parker SJ. Dr. Spock’s Baby and Child Care.
                                 7th edition, Simon & Schuster, New York, NY, 1998.
                                 9. Neumark-Stainzer D, Rock CL, Thornquist
                                 MD, Cheskin LJ, Neuhouser ML, Barnett MJ.
                                 Weight-control behaviors among adults and ado-
                                 lescents: associations with dietary intake. Prev Med.
                                 2000;30:381-391.




                                            Nutrition for Kids           •   PCRM      13
RECIPES
           These recipes and more are available on the PCRM Web site.
       Please visit www.PCRM.org/health/recipes for more healthy options.
Alphabet Soup (Makes about 2 quarts)           •	Heat oil in a large pot and add onion and
2 teaspoons olive oil                          garlic. Cook over medium high heat until
1 small onion, chopped                         onion is soft, about 5 minutes.
2 garlic cloves, minced                        •	Add tomato juice, potato, carrot, celery,
1 quart tomato juice                           Italian herbs, and black pepper. Cover and
1 small potato, scrubbed and cut into chunks   simmer until tender, about 20 minutes.
1 carrot, cut into chunks                      •	Add pasta, chopped greens, and kidney
1 stalk celery, sliced, including top          beans. Simmer until greens and pasta are
2 teaspoons Italian herbs                      tender, about 15 minutes. Extra tomato juice
1/8 teaspoon black pepper                      or water may be added if a thinner soup is
1/2 cup alphabet pasta or small pasta shells   desired.
1 cup finely chopped spinach, kale, or         Nutrition information per 1-cup serving: 128 calories; 5
collard greens                                 g protein; 25 g carbohydrate; 1.5 g fat; 6 g fiber; 203 mg
                                               sodium; calories from protein: 16%; calories from carbo-
1 15-ounce can kidney beans, including         hydrates: 74%; calories from fats: 10%.
liquid
                                               Roasted Sweet Potato Wedges
                                               (Makes 4 servings)
                                               2 medium sweet potatoes, cut into wedges
                                               1/8 teaspoon cinnamon
                                               1/4 teaspoon seasoned salt
                                               1/4 teaspoon ground cumin
                                               1/8 teaspoon black pepper
                                               1/4 teaspoon garlic powder
                                               vegetable oil spray
                                               •	Preheat oven to 450°F.
                                               •	Combine sweet potatoes, cinnamon, salt,
                                               cumin, black pepper, and garlic powder in
                                               a plastic bag. Seal and shake. Place sweet
                                               potatoes on a baking sheet (do not overlap)
                                               coated with vegetable oil spray. Bake for 20
                                               minutes or until very tender, flipping pota-
                                               toes once during cooking.
                                               Nutrition information per serving (1/4 of recipe): 53 calo-
                                               ries; 0.1 g fat; 0 g saturated fat; 2.1% calories from fat; 0
                                               mg cholesterol; 1.2 g protein; 12.1 g total carbohydrates;
                                               4.8 g sugar; 2 g fiber; 106 mg sodium; 24 mg calcium; 0.5
                                                  mg iron; 11.3 mg vitamin C; 6561 mcg beta-carotene;
                                                      0.4 mg vitamin E.




14   Nutrition for Kids   •   PCRM
tein. Look for it in natural food stores and
                                                some supermarkets.
                                                •	Pinto beans or black beans may be substi-
                                                tuted for the kidney beans.
                                                •	Substituting fresh sweet corn cut off the
                                                cob for the canned corn takes a little more
                                                time but adds a deliciously sweet flavor to
                                                this meal.
                                                Nutrition information per 1-cup serving: 92 calories; 2 g
                                                protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg
                                                cholesterol; calories from protein: 9%; calories from car-
                                                bohydrates: 81%; calories from fats: 10%.

Chili Mac (Serves 6)
                                                Curly Pasta Salad (Serves 6 to 8)
Kids of all ages love this easy-to-make meal.
                                                Make early to allow flavors to blend.
8 ounces pasta spirals or macaroni
                                                1 12-ounce package dry rainbow rotini
1 onion, chopped
                                                pasta
2–3 garlic cloves, minced
                                                1 16-ounce package frozen chopped
1 small bell pepper, diced
                                                broccoli and cauliflower, thawed
3/4 cup textured vegetable protein
                                                completely
1 15-ounce can crushed tomatoes
                                                1 cup sliced mushrooms
1 15-ounce can kidney beans, including
                                                4 green onions, chopped
liquid
                                                1 2-ounce jar chopped pimentos
1 15-ounce can corn, including liquid
                                                1/2 cup cherry tomatoes, cut in half
1 tablespoon chili powder
                                                1 cup fat-free honey-Dijon salad dressing
1/2 teaspoon cumin
                                                2 tablespoons soy sauce
•	Cook the pasta in boiling water until it is   freshly ground black pepper, to taste
tender. Drain and rinse it under hot water,     1 dash Tabasco sauce (optional)
then set it aside.
                                                • Cook pasta according to package direc-
• Heat 1/2 cup of water in a large pot, then    tions. Drain and rinse under cool water.
add the chopped onion and garlic. Cook un-
                                                • Place pasta in a large bowl. Add broccoli,
til the onion is soft, about 3 minutes.
                                                cauliflower, mushrooms, green onions, pi-
•	Add the bell pepper, textured vegetable       mentos, and tomatoes.
protein, crushed tomatoes, kidney beans,
                                                • In a small bowl, mix honey-Dijon dress-
corn, spices, and an additional 1/2 cup of
                                                ing and soy sauce. Pour over salad and toss
water. Stir to mix, then simmer over medium
                                                to mix well. Season with black pepper and
heat, stirring occasionally, for 20 minutes.
                                                Tabasco sauce, if using. Refrigerate at least
•	Add the cooked pasta and check the sea-       2 hours before serving.
sonings. Add more chili powder if a spicier     Nutrition information per serving (1/6 of recipe): 304 calo-
dish is desired.                                ries; 1.4 g fat; 0.2 g saturated fat; 4.1% calories from fat;
                                                0 mg cholesterol; 10 g protein; 63.3 g total carbohydrates;
Tips:                                           9.5 g sugar; 6.9 g fiber; 735 mg sodium; 40 mg calcium; 3.3
                                                mg iron; 37.9 mg vitamin C; 498 mcg beta-carotene; 0.8
•	Textured vegetable protein is made from       mg vitamin E.
soybeans and is low in fat and high in pro-




                                                            Nutrition for Kids             •   PCRM       15
Veggies in a Blanket                                             ing sheet and bake until edges are lightly
(Makes 40 individual pieces)                                     browned, about 10 minutes.
                                                                 Note: You will only use about half the sauce.
8 flour tortillas
                                                                 Refrigerate or freeze the remainder for use
½ cup vegan cream cheese or hummus
                                                                 at another time.
4 grated carrots
                                                                 Nutrition information per pizza: 153 calories; 6 g protein;
8 lettuce leaves (or a couple handfuls of                        32 g carbohydrate; 1 g fat; 5 g fiber; 567 mg sodium; calo-
baby spinach leaves), or 1 container sprouts                     ries from protein: 14%; calories from carbohydrates: 78%;
                                                                 calories from fats: 8%.
• Warm tortillas in a dry pan, if desired.
Spread vegan cream cheese or hummus
on the tortillas. Add carrots and lettuce or                     Simply Delicious Winter Squash
spinach. Roll up each tortilla, evenly place                     (Makes 4 servings)
5 toothpicks on each wrap, and slice into 5                      This is a great recipe for preparing
individual rolls per tortilla.                                   butternut squash because it’s quick, easy,
Variations: Add thin sticks of cucumber or                       and absolutely delicious!
sweet red pepper before rolling.
                                                                 1 small butternut squash (about 4 cups
Nutrition information per serving (4 pieces): 102 calories;
2 g fat; 0.3 g saturated fat; 18% calories from fat; 0 mg cho-   diced)
lesterol; 3.8 g protein; 18.6 g carbohydrate; 1.5 g sugar; 3.7   1/2–1 cup water
g fiber; 203 mg sodium; 27 mg calcium; 1.2 mg iron;2.1 mg
vitamin C; 1424 mcg beta-carotene; 0.4 mg vitamin E.
                                                                 2 teaspoon lite soy sauce
                                                                 1 tablespoon maple syrup
Pita Pizzas (Makes 6 pizzas)                                     Peel the squash, then cut it in half and re-
Whole wheat pita bread makes a perfect                           move the seeds. Cut the squash into 1-inch
crust for a child-size pizza and children                        cubes (you should have about 4 cups).
enjoy assembling them once the vegetables                        •	Place into a pot with the water, soy sauce,
have been chopped. In addition to the                            and maple syrup.
toppings listed, you could also add fat-free                     •	Cover and simmer over medium heat until
vegetarian pepperoni slices. YvesVeggie                          the squash is fork tender, about 15 minutes.
Pepperoni and Smart Deli Thin Slices                             Nutrition information per 1-cup serving: 92 calories; 2 g
Lightlife are two delicious options.                             protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg
                                                                 cholesterol; calories from protein: 9%; calories from car-
1 15-ounce can tomato sauce                                      bohydrates: 81%; calories from fats: 10%.
1 6-ounce can tomato paste
1 teaspoon garlic granules or powder
½ teaspoon each: basil, oregano, and thyme
2 green onions, thinly sliced
1 red bell pepper, diced
1 cup chopped mushrooms
6 pieces of whole wheat pita bread
•	Preheat oven to 375°F. Combine tomato
sauce, tomato paste, garlic granules and
herbs. Prepare vegetables as directed.
•	Turn a piece of pita bread upside down
and spread with 2 to 3 tablespoons of sauce.
Top with chopped vegetables. Repeat with
remaining pita breads. Arrange on a bak-



16   Nutrition for Kids              •   PCRM
Apple Crisp (Serves 12)
4 large tart apples
3/4 cup sugar or other sweetener, divided
1/2 cup flour, divided
1 teaspoon cinnamon
1 1/2 cups rolled oats
1/3 cup non-dairy (soy) margarine
• 	 reheat the oven to 350°F.
  P
•	Peel the apples, if desired, then core and
slice them thinly. Toss with 1/2 cup sweet-
ener, 1 tablespoon flour, and cinnamon.
Spread evenly in a 9x13-inch baking dish.
                                                                Strawberry Smoothie
•	Mix the rolled oats with the remaining
flour and sweetener. Add the Spectrum                           (Makes about 2 1-cup servings)
Naturals Spread or soy margarine and work                       1 cup frozen strawberries
the mixture until it is uniformly crumbly.                      1 cup frozen banana chunks
Sprinkle evenly over the fruit.                                 1/2–1 cup unsweetened apple juice
•	Bake for 45 minutes, until lightly browned.                   •	Place all ingredients in a blender and pro-
Let stand 10 minutes before serving                             cess on high speed until smooth, 2 to 3 min-
Nutrition information per serving (1/12th of cake): 228
calories; 3 g protein; 46 g carbohydrate; 5 g fat; 4 g fiber;
                                                                utes, stopping blender occasionally to move
300 mg sodium; calories from protein: 6%; calories from         unblended fruit to the center with a spatula.
carbohydrates: 75%; calories from fats: 19%.                    Serve immediately.
                                                                Nutrition information per 1-cup serving: 121 calories; 3 g
                                                                protein; 31 g carbohydrate; 0.4 g fat; 2 g fiber; 8 mg sodium;
                                                                calories from protein: 3%; calories from carbohydrates:
                                                                94%; calories from fats: 3%.




Nutrition for Kids: A Dietary Approach to Lifelong Health is published by the
Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave., N.W.,
Suite 400, Washington, DC 20016 www.KidsGetHealthy.org.
Nutrition for Kids is not intended as individual medical advice. Always discuss
any diet change with your personal physician or your child’s pediatrician. In some
cases, diet changes may alter medication needs. Persons who follow a vegetarian
diet should be sure to include a source of vitamin B12 in their daily routine, such
as fortified cereals, fortified soymilk, or any common multiple vitamin.
Readers are welcome to reproduce articles from this publication for personal or
educational use without additional permission. Material should not be reproduced
for resale without prior arrangement with the Physicians Committee for Responsible
Medicine. © PCRM, 2009




                                                                            Nutrition for Kids              •   PCRM       17
18
Nutrition for Kids
  •
PCRM
                                               www.KidsGetHealthy.org


                                                                         non-profit
                                                                        organization
                                                                         us postage
                                                                          paid
                     5100 Wisconsin Ave., NW, Suite 400                  Permit 37
                                                                          EriE, PA
                     Washington, DC 20016

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nutrition-for-kids

  • 1. N for Kids utrition A Dietary Approach to Lifelong Health THE PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE
  • 2. Parents know that the road to lifelong W good health starts with healthy eating and plenty of exercise. Getting kids and families started down this path is easy with a little assistance. In this guide you will find the tools you and your family need to achieve many of your health goals: up-to-date health and nutrition information, advice on changing habits, tips to get your family started, and plenty of delicious recipes. II Nutrition for Kids • PCRM
  • 3. Weigh ing In on Health People who maintain a healthy weight throughout life stay well and live longer than those who are overweight. The lifestyle habits that help keep us slim—exercise and a healthy diet—also cut our risk of diabetes, heart disease, high blood pressure, and some cancers. The prevalence of obesity among spectively). One-fourth to one-third of our nation’s youth has more than dou- dieting adolescents practice unhealthy bled in the past 20 years, with close to or even dangerous diets.3 In a study of 5 million youths aged 6 to 17 seriously 5- to 12-year-olds, 45 percent of the overweight or obese. The concerns girls and 20 percent of the boys re- caused by overweight are more than ported having been on a diet.4 Cutting a cosmetic issue. Childhood obesity calories dramatically is often effective leads to a variety of health problems, at lowering weight for the short term, such as type 2 diabetes, high blood but this usually results in overeating pressure, and heart disease.1 The Cen- or binge eating and regaining of any ters for Disease Control and Preven- lost weight. High-protein, low-carbo- tion recently found that 60 percent of hydrate, and very low calorie diets are overweight 5- to 10-year-olds already not safe for children or teens. have at least one risk factor for heart Instead, children (and adults) disease, such as raised blood pressure merely need to switch to healthy foods. or insulin levels.2 When the diet is built from fruits, Many adolescent boys and girls in vegetables, grains, and legumes, weight the United States are currently trying management is much easier, and putting to lose weight (36 and 44 percent, re- limits on calories is unnecessary. For Nutrition for Kids • PCRM 1
  • 4. Food Calories Fat (g) Fiber (g) Veggie Burger 264 0.5 8 Hamburger 444 21 2 Homemade Bean Burrito 255 2 12 Fast-food Chili-Cheese Burrito 390 18 4 example, a veggie burger has 0.5 grams calories). It’s easy to make the switch of fat, saving 20 grams of fat and 180 and well worth the time. calories (compared with a hamburger The bottom line is that it is always at 21 grams of fat and 444 calories). A the right time to adopt a healthful diet. homemade bean burrito with lettuce, It is important to help all children, re- tomato, and salsa has 2 grams of fat, gardless of body size, choose a healthy saving 16 grams of fat and 135 calories eating style and incorporate fun physi- (compared with a fast food chili cheese cal activity into their lives now and in burrito with 18 grams of fat and 390 the future. Food Choices for Achieving and Maintaining a Healthy Weight Choosing a plant-based eating style to be effective in weight loss.7 is a simple way to achieve or maintain Dr. Benjamin Spock, pediatrician, a healthy weight because such dietary medical researcher, and teacher, advised patterns require no calorie counting in his book, Dr. Spock’s Baby and Child and contain the nutrients a fit body Care, that weight-loss programs for needs. Vegetarians have been shown to children should be based on changing be leaner than their meat-eating peers the types of foods children eat rather in a number of scientific studies, 5,6 and than the amount of food they eat. He vegetarian diets have also been shown encouraged shifting the entire family 2 Nutrition for Kids • PCRM
  • 5. their food intake because of concerns about health, body size, or personal be- liefs, they focus too narrowly on just a small number of foods. Exploring the broad range of healthful foods now available makes a menu change fun, nutritious, and sustainable. • Choose low-fat, healthful options away from oily fried foods, meats, whenever possible. Choosing lower fat and dairy products and toward low- recipes and foods and eating a variety fat, plant-based foods­ grains, pasta, : of colors are good ways to ensure that vegetables, legumes, and fruit. When your child’s diet is a healthy one. For this is done, he stated, “weight loss example, oven-roasted potatoes should typically occurs without anyone going be chosen over French fries, pasta with hungry.” 6,8 This is the key to lifelong marinara sauce is a better option than weight maintenance. The scientific spaghetti with meatballs, and fruit sor- evidence is clear: The closer a family bet is just as refreshing but much more gets to a pure vegetarian diet, the healthful than ice cream. The net effect healthier and leaner they’ll be. (not easily detected) is usually a reduc- Here are some ideas for making the tion in the number of calories and fat switch: consumed in any given portion of food. • Identify three or four vegetarian Plus, the introduction of new foods ad- recipes your family already enjoys. Ex- justs the taste buds and develops an ap- amples include bean burritos, pasta preciation for good, wholesome food. with marinara sauce, vegetable stir- • It’s best to avoid foods and beverages fries, and vegetable soup. Next, think of three or four more frequently prepared that have lots of calories but few or no meals that can be easily adapted. For nutrients, such as candy, soda, punch, example, chili can be made vegetarian cookies, and fried snack foods. Fatty with beans, and other favorites, such condiments like creamy salad dress- as sloppy joes and tacos, can be made ings, mayonnaise, butter, and marga- with texturized vegetable protein. rine are best left off the plate. Instead • Experiment and broaden food op- of centering meals around fatty meats tions. Try new foods, recipes, and places and cheese, meals should be built from to eat to keep it interesting and enjoy- the New Four Food Groups: healthy able. Sometimes, when people change grains, legumes, fruit, and vegetables. Nutrition for Kids • PCRM 3
  • 6. The New Four • One serving of vegetables equals 1/2 cup cooked or 1 cup raw (unless Food Groups an amount is specified in the table on Plan menus using the New Four page 6). Food Groups: whole grains, vegeta- bles, legumes, and fruit. Nutritious Legumes, Nuts, Seeds, diets built from these food groups and Non-Dairy Milks help children improve their overall Legumes, nuts, seeds, and non- well-being, maintain a healthy weight, dairy milks are all good sources of and reduce their risk of illnesses that protein, iron, calcium, zinc, and B can arrive later in life. See suggested vitamins. Legumes are great sources servings in the daily meal planning of fiber. table on page 6. • Legumes include beans, such as pinto, navy, kidney, and garbanzo; Whole Grains lentils, black-eyed or split peas; and Grains are rich in fiber and other products made from soybeans, such as complex carbohydrates, as well as tofu, veggie burgers, soy “hot dogs” or protein, B vitamins, and zinc. sandwich slices, and tempeh, a hearty • Whole grains include breads, hot fermented soy product that can be and cold cereals, pasta, cooked grains used in place of meat in many recipes. such as rice and barley, and crackers. • One serving of legumes equals 1/2 • One serving equals 1/2 cup of pas- cup of beans, tofu, or other item (un- ta, grains, or cooked cereal; 3/4 to 1 less an amount is specified). cup of ready-to-eat cereal; 1/2 bun or • Non-dairy milks include breast bagel; or 1 slice of bread. milk and soy formula for infants and toddlers, and rice-, soy-, and other Vegetables vegetable-based milks for children Vegetables are packed with vitamin at least one year of age. Choose for- C, beta-carotene, riboflavin, iron, cal- tified soymilk, whenever possible, or cium, fiber, and other nutrients. use other fortified, plant-based milks • “Dark green vegetables” include such as rice, almond, or oat milk. broccoli, kale, spinach, and collards, • One serving of non-dairy milk turnip greens, mustard greens, beet equals one cup. greens, bok choy, and Swiss chard. • Nuts include whole or chopped • “Other vegetables” refers to all oth- nuts, nut butters, whole seeds, and er vegetables, fresh or frozen, raw or seed butters. cooked. • One to two servings of nuts may be 4 Nutrition for Kids • PCRM
  • 7. Sample Menus for Children and Teens Breakfast: Oatmeal with applesauce, calcium-fortified orange juice Lunch: Alphabet Soup*, whole-grain crackers, carrot sticks, banana, soymilk Dinner: Pita Pizzas*, fresh cucumber, cherry tomatoes Snacks: Peach, granola or energy bar, soymilk Breakfast: Whole-grain cereal with strawberries and soymilk Lunch: Hummus sandwich on whole-wheat bread with lettuce and tomato, apple juice, orange wedges, carrot sticks Dinner: Baked veggie nuggets, simply delicious winter squash*, roasted sweet potato wedges*, soymilk, fruit salad Snacks: Graham crackers, banana Breakfast: Granola topped with soy yogurt, blueberries, and almonds; calcium-fortified orange juice Lunch: Curly pasta salad*, green salad, whole-wheat bread, apple Dinner: Chili Mac*, green beans, cucumber salad Snacks: Popcorn, trail mix, strawberries Breakfast: Bagel with peanut butter and banana, calcium-fortified orange juice Lunch: Veggies in a blanket*, pretzels, apple Dinner: Bean burrito with lettuce, tomato, and guacamole; rice; baked tortilla chips and salsa; peach; soymilk Snacks: Hummus and crackers, strawberry smoothie* * See delicious recipes starting on page 14 included in a healthy diet, but they are that are high in vitamin C—citrus optional. One serving of nuts or nut fruits, melons, and strawberries are all butters equals 1 tablespoon. good choices. • Fruits include all fruits, fresh or fro- Fruits zen, raw or cooked, and fruit juices. Fruits are rich in fiber, vitamin C, • One serving equals 1/2 cup cooked and beta-carotene. Be sure to include fruit, 1/2 cup fruit juice, 1/4 cup dried at least one serving each day of fruits fruit, or 1 piece of whole fruit. Nutrition for Kids • PCRM 5
  • 8. Daily Meal Planning for Children and Teens Planning meals based on the New Four Food Groups is easy and helps ensure grow- ing kids get the important nutrients they need. Caloric needs vary from child to child. The following guidelines are general ones. 1- to 4-Year-Olds 5- to 6-Year-Olds 7- to 12-Year-Olds 13- to 19-Year-Olds Whole Grains, Breads, Cereals 4 servings 6 servings 7 servings 10 servings Vegetables 2 to 4 tbsp dark 1/4 cup dark green 1 serving dark 2 servings dark green vegetables vegetables green vegetables green vegetables 1/4 to 1/2 cup 1/4 to 1/2 cup 3 servings other 3 servings other other vegetables other vegetables vegetables vegetables Legumes, Nuts, Seeds, Non-Dairy Milks 1/2 to 1 cup 2 servings 3 servings 1/4 to 1/2 cup legumes legumes legumes legumes 3 servings soymilk 3 servings soymilk 2 to 3 servings or other non-dairy or other non-dairy soymilk or other milk milk non-dairy milk Fruits 3/4 to 1 to 2 cups 3 servings 4 servings 1 1/2 cups Be sure to include a source of vitamin B12, such as any typical children’s multivitamin or vitamin-fortified cereals or soymilk. 6 Nutrition for Kids • PCRM
  • 9. Kid Classics soymilk to vanilla soy ice cream, and blend to make a smoothie. A scoop Being vegetarian doesn’t mean hav- of fruit sorbet—found at many of the ing to give up classic kid fare. While large ice cream chains or at the grocery whole, unprocessed fruits, vegetables, store—is also a refreshing treat on a grains, and legumes should be chosen hot summer day. first, many of the foods children enjoy can be adapted to fit into a vegetarian • Fast Food. Burger King now of- menu. Here are some tips: fers a terrific veggie burger. Other food chains, such as Subway, also offer • Pizza. Try ordering pizza without vegetarian sandwiches, and Taco Bell the cheese and pile on the veggies. If makes a bean burrito (just ask them to making pizza at home, top it off with hold the cheese). vegetarian meatballs or veggie pep- peroni. Keeping Kids Moving • Hamburgers and Hot Dogs. Both Fitness has four dimensions: car- come in a wide variety of veggie ver- diovascular, strength, flexibility, and sions. You can microwave them, bake body composition. Activities that get them, grill them, and top them with the heart pumping, such as running, everything you traditionally enjoy, in- swimming, bicycling, aerobics, and cluding soy cheese. playing sports or outdoor neighbor- • Cold Cut Sandwiches. Even the hood games, improve cardiovascular cold cut now has a non-meat alterna- fitness. Strength-training activities, tive. Try a slice of veggie ham, veggie such as weightlifting, push-ups, and turkey, or veggie salami topped with sit-ups, as well as many daily tasks, lettuce and tomato and a thin layer of such as digging in the garden, lifting mustard or vegan mayonnaise between boxes, carpentry work, and so forth, slices of whole-wheat bread. improve muscular development and • Chicken Nuggets and Buffalo bone strength. Stretching, yoga, gym- Wings. Several companies offer these nastics, dancing, and martial arts all traditional favorites in veggie form promote flexibility. (look in the frozen food section of the A healthy body composition supermarket). Just add ketchup or bar- balances muscle and other lean tissue beque sauce. with an appropriate amount of fat tissue • Ice Cream. Soy ice cream is a ter- for a child’s age and sex. Healthy body rific non-dairy alternative that comes compositions are achieved through a in a variety of styles and flavors. For combination of an active lifestyle and a twist, add frozen fruit and a little a healthy menu of grains, vegetables, Nutrition for Kids • PCRM 7
  • 10. Healthy Snacks Young children have high calorie and nutrient needs but their stomachs are small. Teenagers also often have high energy needs combined with busy schedules. Keep delicious, healthy snack choices on hand both at home and in the lunchbox. Snacking on the New Four Food Groups Whole Grains, Breads, Cereals Pita chips, pretzels, whole-grain crackers, granola, whole-grain cereal, popcorn, energy bars, granola bars Vegetables Baby carrots, celery stalks (try with peanut butter and raisins), cucum- ber, carrots, tomato with non-dairy dressing, salsa (try with pita chips) Legumes, Nuts, Seeds, Non-Dairy Milks Hummus (try on carrots or crackers), nut butters (put on bread or fruit), edamame (whole cooked soybeans), soy yogurt (sprinkle with granola), soymilk, rice milk, almond milk Fruits Fortified orange juice, whole fresh fruits, dried fruit, applesauce, fruit cups, frozen grapes or banana slices legumes, and fruit. diet. Keep in mind that the two main Find ways to incorporate fun physi- contributors to overweight are low ac- cal activity into your family activities tivity level and diets based on meat, daily. Kids need to be engaged in active dairy products, and high-calorie, low– pursuits for at least an hour each day. nutrient foods. The first step toward health is assessing a family’s lifestyle Already Over- by looking at eating patterns and ac- weight Children tivities to determine what changes are Just as with slim children, it is al- needed to promote fitness and achieve ways the right time to adopt a healthy a healthy weight. The easiest and most 8 Nutrition for Kids • PCRM
  • 11. effective method is for all mem- etables, and fruit. Plan menus using the bers of the family to shift together— New Four Food Groups (see page 4). if possible—to a healthier lifestyle. The same healthy habits will benefit the rest Learning to of the family as well as the overweight Eat Well child. • Limit the quantities of highly pro- Focusing on overall health is a bet- cessed foods and sugary beverages ter choice than embarking on a low- (otherwise known as “empty-calorie” calorie diet for achieving fitness and a foods) and help children understand healthy weight. The idea is to focus on reasonable portion sizes. Under most the quality of what is being eaten, not circumstances, restricting the calorie so much on the quantity. The healthiest intake of children is not recommend- diet avoids animal products completely ed. Children continue to grow and de- and is built from grains, legumes, veg- velop into their early twenties, so they can’t afford to short change nutrients. Healthy body However, switching out the empty- calorie foods with healthy options en- compositions sures growing kids get everything they need—except the excess calories! are achieved • Children and adults can benefit through a from learning to listen to their natural hunger and fullness cues, rather than combination focusing on “cleaning their plates.” of an active Help children learn to pay attention to natural internal signals to keep from lifestyle and overeating. If a child does not want to finish his or her meal now, the plate a healthy can be wrapped and saved for when the menu of child is hungry later. Promising dessert as a reward is best avoided as well, as it grains, encourages overeating and makes less healthful foods seem special. vegetables, • Teach children the value of good nu- legumes, trition. Parents, guardians, and teach- ers can work with children toward an and fruit. understanding that food is a fuel for health and fitness rather than a com- Nutrition for Kids • PCRM 9
  • 12. fort, friend, enemy, or boredom re- liever. Reading books to children that present nutrition in a fun and interesting manner is also a good educational method. • Get kids engaged in the food procurement and preparation process. Gardening; picking berries, apples, or other produce at you-pick farms; or vis- iting the local farmers market or fruit stand can spark an interest in healthy foods. Invite them also to participate in menu planning, as well as cooking. Even very small children can help stir cold or room temperature items, or wash pro- duce, or pour ingredients. These simple experiential lessons will often go a long way to promot- ing healthy eating habits. Fitting In Fun Physical Activities • Encourage children to play with other children and to do active things with family members. Most communi- ties have locally organized activity pro- grams after school, on the weekends, and during the summer. Since gym class and team sports are not every child’s cup of tea, encouraging individual interests such as ice skating, ballet dancing, or skateboarding are important, too. • It’s important for parents to talk with children about their activity pat- terns. Children should be active for at least 60 minutes on most days. Seden- tary activities, such as TV watching 10 Nutrition for Kids • PCRM
  • 13. and computer time, should stand what options should be avail- be limited except when able for children. homework requires it. It Here are some suggestions for im- is estimated that, on aver- proving the healthfulness of foods age, U.S. preschoolers spend eaten in schools: 23 hours a week in front of • Pack a lunch. Bean and pasta sal- the television and grade-school ads, grilled tofu, burritos, and sand- students watch for 29 hours each wiches make great lunches and are week. Add to this the time spent easy to pack. Last night’s leftovers are playing video games, using the In- also a great, simple choice. Make sure ternet, doing homework, and eating to include several healthy snacks. dinner—and many kids spend a lot of time sitting still. • Encourage your child to request that low-fat, vegetarian entrées be Encouraging children to adopt a placed on the lunch line. Demand for healthy, vegetarian eating style and these items will encourage the food teaching them to enjoy being active service to incorporate healthier foods are likely the most important lessons into their menu cycle. children can learn for their long-term health. • Parents can also volunteer their time. Get involved with the PTA or Surviving the directly with the food service. Work with them to help incorporate health- School Lunch Line ier foods. Some parents have even Families can also help to improve donated recipes or planned healthy “get healthy” opportunities for chil- snack breaks in the classroom. dren in schools. Many schools are See www.HealthySchoolLunches.org under financial pressure to down- for more information. size health and physical education programs, so health-conscious fami- Staying Clear of lies should support school districts in their efforts to promote wellness the “Food Fight” and physical education and to Children learn very early that what promote healthier lunches in they eat is important to their parents, the cafeteria. School lunch pro- and they often use this knowledge to grams are required to provide their advantage. Parents may sit for nutritious, low-cost meals to hours at the dinner table with their students; parents and teachers children until they finish their last can help school officials under- asparagus spear. Food can be used as a reward, a way to exert control, or a Nutrition for Kids • PCRM 11
  • 14. way to rebel. Rewarding kids for good to using non-food treats as grades or good behavior with sweets rewards, such as a warm con- can set up internal conflicts about versation, reading, going to a food. This is especially true if the re- movie or the park, making some- wards are in opposition to current thing, calling Grandma or a friend, goals for health or body image. If not or engaging in physical activities. dealt with early, these “food fights” • Set clear divisions of responsibil- may extend into adult life as well. ity. If a “food fight” develops, parents Finding a way to sidestep the “food should define responsibilities around fight” is a priority. If a child is having foods. The parent is responsible for trouble sticking to healthful foods, the providing appropriate food choices. following strategies may be helpful. The child is responsible for choosing • Stock the kitchen with healthy what to eat among the choices offered. foods. Having plenty of fruits, veg- • Allow for healthy treats. Fresh-fruit etables, grains, and beans on hand smoothies, a colorful cup of berries in and keeping unhealthful foods out of season, or a vegetable dish prepared a the house are simple ways to eliminate favorite way can all be special treats conflict over which type of food to and prevent a family from feeling de- prepare or eat. prived. • Focus on food as a fuel for health. Choosing a simple, health-giving way Sticking with It of eating like the one suggested in The ease with which kids transition these pages and explaining to children into and stick with this healthy dietary why it is important to eat this way will pattern can be positively influenced by help them to appreciate and choose a variety of factors. Family support, in healthful foods. terms of providing healthy foods and • Reduce the emphasis on food in setting a good example, as well as edu- daily life. When people solve problems cation about nutrition, are key. If your by eating or congratulate themselves children have convictions about the with food, the importance of food has welfare of animals or reducing the im- gotten out of control. Finding other pact on the environment and/or have solutions to problems, such as talking a clear understanding of the health about them, writing about them in a value of good eating habits, they will journal, or taking a walk or a bike ride be more likely to make the switch eas- to figure out possible steps to take, are ily and be able to maintain this diet, much healthier and more productive. not only while away from home, but Families should become accustomed throughout their lives. 12 Nutrition for Kids • PCRM
  • 15. For More Information, Please visit our Web sites: PCRM’s Healthy Kids PCRM’s Healthy School Campaign site: Lunch Campaign site: www.KidsGetHealthy.org www.HealthySchoolLunches.org Our main site for general The PCRM Marketplace Online for information about healthy information on our book, eating and our campaigns: Healthy Eating for Life for Children: www.PCRM.org pcrm.org.shop For nutrition tips and recipes for all age groups, visit www.NutritionMD.org References When children 1. Vanhalla M. Childhood weight and metabolic syn- drome in adults. Ann Med 1999;31:236-239. eat healthful foods 2. Centers for Disease Control and Prevention. CDC Surveillance Summaries, July 7, 2000. MMWR and stay physically 2000;49 (No. SS-6). 3. Neumark-Stainzer D, Rock CL, Thornquist active, their bodies MD, Cheskin LJ, Neuhouser ML, Barnett MJ. Weight-control behaviors among adults and ado- lescents: associations with dietary intake. Prev Med. find their way to 2000;30:381-391. 4. Neumark-Stainzer D, Hannan PJ. Weight-related a healthy size behaviors among adolescent girls and boys: results from a national survey. Arch Pediatr Adolesc Med. and shape in a 2000;154:569-577. 5. Snowdon DA, Phillips RL. Does a vegetarian diet pleasurable and reduce the occurrence of diabetes? Am J Publ Health. 1985;75:507-512. sustainable way. 6. Melby CL, Goldflies DG, Hyner GCL, Lyle RM. Relations between vegetarian/non-vegetarian diets and blood pressure in black and white adults. Am J Publ Health. 1989;79:1283-1288. 7. Ornish D, Brown SE, Scherwitz LW, Billings JH, et al. Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet. 1990;336:129-133. 8. Spock B, Parker SJ. Dr. Spock’s Baby and Child Care. 7th edition, Simon & Schuster, New York, NY, 1998. 9. Neumark-Stainzer D, Rock CL, Thornquist MD, Cheskin LJ, Neuhouser ML, Barnett MJ. Weight-control behaviors among adults and ado- lescents: associations with dietary intake. Prev Med. 2000;30:381-391. Nutrition for Kids • PCRM 13
  • 16. RECIPES These recipes and more are available on the PCRM Web site. Please visit www.PCRM.org/health/recipes for more healthy options. Alphabet Soup (Makes about 2 quarts) • Heat oil in a large pot and add onion and 2 teaspoons olive oil garlic. Cook over medium high heat until 1 small onion, chopped onion is soft, about 5 minutes. 2 garlic cloves, minced • Add tomato juice, potato, carrot, celery, 1 quart tomato juice Italian herbs, and black pepper. Cover and 1 small potato, scrubbed and cut into chunks simmer until tender, about 20 minutes. 1 carrot, cut into chunks • Add pasta, chopped greens, and kidney 1 stalk celery, sliced, including top beans. Simmer until greens and pasta are 2 teaspoons Italian herbs tender, about 15 minutes. Extra tomato juice 1/8 teaspoon black pepper or water may be added if a thinner soup is 1/2 cup alphabet pasta or small pasta shells desired. 1 cup finely chopped spinach, kale, or Nutrition information per 1-cup serving: 128 calories; 5 collard greens g protein; 25 g carbohydrate; 1.5 g fat; 6 g fiber; 203 mg sodium; calories from protein: 16%; calories from carbo- 1 15-ounce can kidney beans, including hydrates: 74%; calories from fats: 10%. liquid Roasted Sweet Potato Wedges (Makes 4 servings) 2 medium sweet potatoes, cut into wedges 1/8 teaspoon cinnamon 1/4 teaspoon seasoned salt 1/4 teaspoon ground cumin 1/8 teaspoon black pepper 1/4 teaspoon garlic powder vegetable oil spray • Preheat oven to 450°F. • Combine sweet potatoes, cinnamon, salt, cumin, black pepper, and garlic powder in a plastic bag. Seal and shake. Place sweet potatoes on a baking sheet (do not overlap) coated with vegetable oil spray. Bake for 20 minutes or until very tender, flipping pota- toes once during cooking. Nutrition information per serving (1/4 of recipe): 53 calo- ries; 0.1 g fat; 0 g saturated fat; 2.1% calories from fat; 0 mg cholesterol; 1.2 g protein; 12.1 g total carbohydrates; 4.8 g sugar; 2 g fiber; 106 mg sodium; 24 mg calcium; 0.5 mg iron; 11.3 mg vitamin C; 6561 mcg beta-carotene; 0.4 mg vitamin E. 14 Nutrition for Kids • PCRM
  • 17. tein. Look for it in natural food stores and some supermarkets. • Pinto beans or black beans may be substi- tuted for the kidney beans. • Substituting fresh sweet corn cut off the cob for the canned corn takes a little more time but adds a deliciously sweet flavor to this meal. Nutrition information per 1-cup serving: 92 calories; 2 g protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg cholesterol; calories from protein: 9%; calories from car- bohydrates: 81%; calories from fats: 10%. Chili Mac (Serves 6) Curly Pasta Salad (Serves 6 to 8) Kids of all ages love this easy-to-make meal. Make early to allow flavors to blend. 8 ounces pasta spirals or macaroni 1 12-ounce package dry rainbow rotini 1 onion, chopped pasta 2–3 garlic cloves, minced 1 16-ounce package frozen chopped 1 small bell pepper, diced broccoli and cauliflower, thawed 3/4 cup textured vegetable protein completely 1 15-ounce can crushed tomatoes 1 cup sliced mushrooms 1 15-ounce can kidney beans, including 4 green onions, chopped liquid 1 2-ounce jar chopped pimentos 1 15-ounce can corn, including liquid 1/2 cup cherry tomatoes, cut in half 1 tablespoon chili powder 1 cup fat-free honey-Dijon salad dressing 1/2 teaspoon cumin 2 tablespoons soy sauce • Cook the pasta in boiling water until it is freshly ground black pepper, to taste tender. Drain and rinse it under hot water, 1 dash Tabasco sauce (optional) then set it aside. • Cook pasta according to package direc- • Heat 1/2 cup of water in a large pot, then tions. Drain and rinse under cool water. add the chopped onion and garlic. Cook un- • Place pasta in a large bowl. Add broccoli, til the onion is soft, about 3 minutes. cauliflower, mushrooms, green onions, pi- • Add the bell pepper, textured vegetable mentos, and tomatoes. protein, crushed tomatoes, kidney beans, • In a small bowl, mix honey-Dijon dress- corn, spices, and an additional 1/2 cup of ing and soy sauce. Pour over salad and toss water. Stir to mix, then simmer over medium to mix well. Season with black pepper and heat, stirring occasionally, for 20 minutes. Tabasco sauce, if using. Refrigerate at least • Add the cooked pasta and check the sea- 2 hours before serving. sonings. Add more chili powder if a spicier Nutrition information per serving (1/6 of recipe): 304 calo- dish is desired. ries; 1.4 g fat; 0.2 g saturated fat; 4.1% calories from fat; 0 mg cholesterol; 10 g protein; 63.3 g total carbohydrates; Tips: 9.5 g sugar; 6.9 g fiber; 735 mg sodium; 40 mg calcium; 3.3 mg iron; 37.9 mg vitamin C; 498 mcg beta-carotene; 0.8 • Textured vegetable protein is made from mg vitamin E. soybeans and is low in fat and high in pro- Nutrition for Kids • PCRM 15
  • 18. Veggies in a Blanket ing sheet and bake until edges are lightly (Makes 40 individual pieces) browned, about 10 minutes. Note: You will only use about half the sauce. 8 flour tortillas Refrigerate or freeze the remainder for use ½ cup vegan cream cheese or hummus at another time. 4 grated carrots Nutrition information per pizza: 153 calories; 6 g protein; 8 lettuce leaves (or a couple handfuls of 32 g carbohydrate; 1 g fat; 5 g fiber; 567 mg sodium; calo- baby spinach leaves), or 1 container sprouts ries from protein: 14%; calories from carbohydrates: 78%; calories from fats: 8%. • Warm tortillas in a dry pan, if desired. Spread vegan cream cheese or hummus on the tortillas. Add carrots and lettuce or Simply Delicious Winter Squash spinach. Roll up each tortilla, evenly place (Makes 4 servings) 5 toothpicks on each wrap, and slice into 5 This is a great recipe for preparing individual rolls per tortilla. butternut squash because it’s quick, easy, Variations: Add thin sticks of cucumber or and absolutely delicious! sweet red pepper before rolling. 1 small butternut squash (about 4 cups Nutrition information per serving (4 pieces): 102 calories; 2 g fat; 0.3 g saturated fat; 18% calories from fat; 0 mg cho- diced) lesterol; 3.8 g protein; 18.6 g carbohydrate; 1.5 g sugar; 3.7 1/2–1 cup water g fiber; 203 mg sodium; 27 mg calcium; 1.2 mg iron;2.1 mg vitamin C; 1424 mcg beta-carotene; 0.4 mg vitamin E. 2 teaspoon lite soy sauce 1 tablespoon maple syrup Pita Pizzas (Makes 6 pizzas) Peel the squash, then cut it in half and re- Whole wheat pita bread makes a perfect move the seeds. Cut the squash into 1-inch crust for a child-size pizza and children cubes (you should have about 4 cups). enjoy assembling them once the vegetables • Place into a pot with the water, soy sauce, have been chopped. In addition to the and maple syrup. toppings listed, you could also add fat-free • Cover and simmer over medium heat until vegetarian pepperoni slices. YvesVeggie the squash is fork tender, about 15 minutes. Pepperoni and Smart Deli Thin Slices Nutrition information per 1-cup serving: 92 calories; 2 g Lightlife are two delicious options. protein; 19 g carbohydrate; 1 g fat; 102 mg sodium; 0 mg cholesterol; calories from protein: 9%; calories from car- 1 15-ounce can tomato sauce bohydrates: 81%; calories from fats: 10%. 1 6-ounce can tomato paste 1 teaspoon garlic granules or powder ½ teaspoon each: basil, oregano, and thyme 2 green onions, thinly sliced 1 red bell pepper, diced 1 cup chopped mushrooms 6 pieces of whole wheat pita bread • Preheat oven to 375°F. Combine tomato sauce, tomato paste, garlic granules and herbs. Prepare vegetables as directed. • Turn a piece of pita bread upside down and spread with 2 to 3 tablespoons of sauce. Top with chopped vegetables. Repeat with remaining pita breads. Arrange on a bak- 16 Nutrition for Kids • PCRM
  • 19. Apple Crisp (Serves 12) 4 large tart apples 3/4 cup sugar or other sweetener, divided 1/2 cup flour, divided 1 teaspoon cinnamon 1 1/2 cups rolled oats 1/3 cup non-dairy (soy) margarine • reheat the oven to 350°F. P • Peel the apples, if desired, then core and slice them thinly. Toss with 1/2 cup sweet- ener, 1 tablespoon flour, and cinnamon. Spread evenly in a 9x13-inch baking dish. Strawberry Smoothie • Mix the rolled oats with the remaining flour and sweetener. Add the Spectrum (Makes about 2 1-cup servings) Naturals Spread or soy margarine and work 1 cup frozen strawberries the mixture until it is uniformly crumbly. 1 cup frozen banana chunks Sprinkle evenly over the fruit. 1/2–1 cup unsweetened apple juice • Bake for 45 minutes, until lightly browned. • Place all ingredients in a blender and pro- Let stand 10 minutes before serving cess on high speed until smooth, 2 to 3 min- Nutrition information per serving (1/12th of cake): 228 calories; 3 g protein; 46 g carbohydrate; 5 g fat; 4 g fiber; utes, stopping blender occasionally to move 300 mg sodium; calories from protein: 6%; calories from unblended fruit to the center with a spatula. carbohydrates: 75%; calories from fats: 19%. Serve immediately. Nutrition information per 1-cup serving: 121 calories; 3 g protein; 31 g carbohydrate; 0.4 g fat; 2 g fiber; 8 mg sodium; calories from protein: 3%; calories from carbohydrates: 94%; calories from fats: 3%. Nutrition for Kids: A Dietary Approach to Lifelong Health is published by the Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave., N.W., Suite 400, Washington, DC 20016 www.KidsGetHealthy.org. Nutrition for Kids is not intended as individual medical advice. Always discuss any diet change with your personal physician or your child’s pediatrician. In some cases, diet changes may alter medication needs. Persons who follow a vegetarian diet should be sure to include a source of vitamin B12 in their daily routine, such as fortified cereals, fortified soymilk, or any common multiple vitamin. Readers are welcome to reproduce articles from this publication for personal or educational use without additional permission. Material should not be reproduced for resale without prior arrangement with the Physicians Committee for Responsible Medicine. © PCRM, 2009 Nutrition for Kids • PCRM 17
  • 20. 18 Nutrition for Kids • PCRM www.KidsGetHealthy.org non-profit organization us postage paid 5100 Wisconsin Ave., NW, Suite 400 Permit 37 EriE, PA Washington, DC 20016