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Childhood Nutrition

Childhood nutrition

Definition

Childhood nutrition involves making sure that children eat healthy foods to help them grow and develop normally, as well as to prevent obesity and future disease.

The traditional or mainstream approach to good childhood nutrition is to follow suggestions based on dietary guidelines that are appropriate for a child's age and development level and that have been developed and recommended by government, research, and medical professionals. The guidelines include selections from different food groups to provide the vitamins and minerals young bodies need for natural growth and activity. The U.S. Department of Agriculture's (USDA's) Food Guide Pyramid recommends how many servings a day a child should eat of each food group, such as milk, vegetables, fruits, fats, and meats, and asserts that by sticking closely to the guidelines, parents can ensure their children get a well-balanced diet that supplies the vitamins, minerals and calories they need to support growing bodies and active lifestyles. However, in this age of what has been called "advanced medicine," there are those who seek to understand why so many among us, especially children, suffer from so much serious illness.

Origins

Humans, unlike plants, cannot manufacture the nutrients they need to function. Each culture over centuries has developed its own traditional diet. In western civilization's modern times, many of these diets have developed into convenient, fatty and sugary foods, leading to obesity even in children and teens.

Advice on nutritional choices predates recorded language, but the first science-based approach to a healthy diet probably began just over 100 years ago. W. O. Atwater, the first director of the Office of Experiment Stations in the U.S. Department of Agriculture (USDA) and a pioneer in the field of nutrition investigation, developed some of the components needed for a food guide. He created food tables with data on protein, fat, carbohydrate, mineral matter, and fuel value for common foods.

Food guides with food groups similar to those used today first appeared in USDA publications in 1916 and were developed by nutrition specialist Caroline L. Hunt. Interestingly, the first daily food guide was published under the title Food for Young Children. In the early 1930s, the Depression caused economic restraints on families and the USDA responded with advice on how to select healthy foods more cheaply. In 1941, the Food and Nutrition Board of the National Academy of Sciences released the first recommended dietary allowances (RDAs) for calories and essential nutrients. The nine nutrients included on the list were protein, iron, calcium , vitamins A, C, and D, thiamin, riboflavin , and niacin .

Throughout the years following the release of the first guidelines, recommendations were debated and revised. The new food guide was first presented in 1984 as a food wheel. The USDA first used a pyramid to represent the food groups in 1992 after intensive research on the most effective way to visually communicate healthy eating by portion and food choice. Although it has been modified over the years, the pyramid has continued to represent the food groups and a new revision of the guidelines has been planned for 2005.

Annemarie Colbin was brought up on a European vegetarian diet before she came to the United States in 1961. In her search for optimum health and the ability to control how one feels by what one eats, she became a professional cook, lecturer, founder of the Natural Gourmet Cookery School in New York City, and author of best-selling books Food and Healing, The Book of Whole Meals, and The Natural Gourmet, as well as articles appearing in the New York Times and Cosmopolitan.

In Chapter One of Food and Healing, Colbin looks at the health of children and she points out that:

  • A child born today can expect to live 26 years longer than a child born in 1900, but a person who has already reached 45 today can expect to live only four or five years longer than a person born in 1900.
  • The following childhood problems that were rare in 1900 are now so prevalent that they are called "the new morbidity (an unsound, gruesome condition)": learning difficulties, behavioral disturbances, speech and hearing difficulties, faulty vision, serious dental misalignment.
  • The average child loses three permanent teeth to decay by age 11, eight or nine by age 17, and 94% of adolescents have cavities in their permanent teeth.
  • Among children, tuberculosis is on the rise
  • By the mid-1980s, cancer as a killer of children and adolescents was surpassed by only accidents and violence.

Colbin cites statistics linking children to emotional disorders and violence, indicating that at any given time, as much as a quarter of our population is estimated to suffer from depression, anxiety, or other emotional disorders; that suicide is the ninth leading cause of death for all age groups; and that there may be as many as four million cases of child abuse every year, at least 2,000 of which result in death. She then states, "All this violence is no longer viewed as purely psychological. A growing body of research links mood, violent behavior, and even criminal behavior with various physiological imbalances: an over-active thyroid, an excess of testosterone (male hormones), allergies , low blood sugar. Lead poisoning, vitamin deficiencies, and of course alcohol and drugs all alter physiology as well as mood. Behavioral problems have even been associated with a lack of natural light, insofar as light plays a vital role in the metabolism of calcium, a mineral widely regarded as 'nature's tranquilizer.'"

Based on these statistics and many more that she cites, Colbin contends that proper nutrition plays a key role in disease prevention. She indicates that she sees three major errors in our contemporary assumptions about health and illness: the belief that physiological symptoms such as headaches, fevers, etc. are mistaken reactions of the body to normal stimuli; the belief that surgical intervention or chemical substances, natural or artificial in origin, can restore health by stopping the disease process; and the belief that dietary habits are unrelated to symptoms or illnesses. Although the last belief is slowly changing, it has a long way to go. For example, she points out, many people are still buying antacids for digestive distress without changing their diet.

Benefits

The Food Guide Pyramid and other healthy eating recommendations generally apply to children age two and older. When used as a starting point for planning family meals and snacks, applying these sensible recommendations to children's daily diets can encourage good eating habits at an early age. This will help children develop mentally and physically according to growth charts and other measurements set by pediatricians (physicians who specialize in caring for children) and will help prevent future problems with overeating or with eating disorders. Many nutritional experts agree that if children eat a balanced diet that includes all of the recommended food groups, they will not need to take vitamin/mineral supplements. Also, eating a balanced diet with a variety of foods will give children the energy they need to stay physically active, which is important to their growth and mental health, and in keeping obesity in check.

Description

In spite of recommendations, the diet quality of most children is not what it should be. The USDA surveyed American children ages two to nine in 1998 and found that up to 8% of them had a poor diet, while as many as 80% of those ages seven to nine had a diet that needed improvement. The Centers for Disease Control (CDC) defines childhood obesity at a level above the 95th percentile of body mass index for his or her age group. Body mass index (BMI) is a measurement system used to assess if a child (or adult) is underweight, overweight, or at risk for becoming overweight. Pediatricians use height and weight measurements taken at a child's regular checkups to determine his or her BMI. To help guide parents and others in making good nutritional choices to keep BMI in line with normal growth and just to keep children healthy, the American Medical Association (AMA) suggests the following food choices for children, based on the USDA guidelines.

Children two to five years of age

The AMA and USDA recommend food guidelines for young children similar to those for older children and adults, but with smaller portions. When looking at a range of portion sizes, parents and those who care for young children should choose the smaller portion sizes for children age two or three, and go with a slightly larger portion for children who are age four or five. Daily recommendations include:

  • four to five servings of breads, cereals, rice, pasta
  • two or more servings of vegetables
  • two or more servings of fruit
  • three to four servings of dairy products
  • two or three servings of meat, fish, poultry, legumes (beans, lentils, peas)

After age two, a child needs less fat than an infantabout 30% of daily calories. After age three, fiber becomes more important in a child's diet and can impact future heart health.

Calcium requirements steadily increase as children get older, from 500 mg a day at age three to 800 mg a day at age four to eight. There is more calcium in the body than any other mineral. Calcium works together with phosphorus (two parts calcium to one part phosphorus) for healthy bones and teeth and works together with magnesium (two parts calcium to slightly over one part magnesium) to prevent cardiovascular (blood vessels of the heart) and other degenerative diseases. In order for calcium to be absorbed by the body, it must also have sufficient amounts of vitamins C, D and A. In addition to food sources, an hour of sunshine each day can also provide a child with his/her daily vitamin D requirement.

Children six to twelve years of age

By the time children reach age five or six, they begin to tell parents what foods they like. Parents and those who care for the children can help select foods from each recommended group that a child will enjoy. Calorie requirements and portion sizes increase as children get older: between ages six and ten, boys and girls need between 1,600 and 2,400 calories each day. Because of puberty and adolescent growth, between ages 10 and 12, girls need about 200 more calories a day. Boys will begin needing about 500 more calories a day after age 12. The following servings per day are recommended for children ages six to twelve:

  • six to 11 servings of breads, cereals, rice, pasta
  • three to five servings of vegetables
  • two to four servings of fruit
  • three or four servings of dairy products
  • two or three servings of meat, fish, poultry, legumes

By age six, children still need only about 30% of calories from fat. Nutritionists say that by adding five to the child's age, parents can estimate the number of fiber grams a child needs each day. Calcium requirements continue to rise, from 800 mg a day at ages four to eight to 1,300 mg each day for children beginning at age nine.

Preparations

Getting children to eat the right foods is easy if they begin good eating habits at a young age and if they are offered a variety of healthy foods. Many books, magazines, and web sites offer tips on making healthy foods interesting. Some suggestions for each food group follow.

  • breads, cereals, and pastas including whole grain breads, unsweetened cereals, unrefined rice, whole grain crackers, cornbread, rice cakes
  • vegetable servings from cooked or raw vegetables such as asparagus, beets, broccoli, carrots, corn, green and red peppers, green beans, kale, peas, pumpkin, squash, sweet potato, tomato, zucchini, or vegetable juice
  • good fruit choices such as apples, applesauce, bananas, cantaloupe, apricots, peaches, unsweetened fruit cocktail, plums, grapefruit, kiwi, nectarines, strawberries, watermelon, and fresh fruit juices
  • milk, low-fat yogurts and cheeses are good dairy sources, as are low-fat cottage cheese, custard, ice milk, and occasional ice cream servings
  • meat, fish, poultry, and legume choices include lean meats, dried beans, peanut butter, shellfish, dried peas, lentils, tofu, and reduced-fat cold cuts

To reduce fat in a child's diet, parents can switch to low-fat or non-fat milk; remove skin from poultry or trim fat from red meat; reduce use of margarine and butter; use low-fat cooking methods such as baking, broiling, and steaming; and serve foods rich in fiber. Fresh salads can improve fiber in diet, as can adding oat or wheat bran to baked foods. Good, easy-to-assimilate sources of calcium for children, besides milk and cheeses, are tofu made with calcium sulfate; soup made with fish, fowl or beef bones and one tablespoon of wine vinegar to draw out the calcium into the broth; canned salmon and sardines with bones; sesame seeds and tahini (ground sesame seed butter); beans and nuts; calcium-fortified fresh orange juice; greens, especially broccoli, collards, kale, mustard, turnip tops, parsley, watercress and dandelion; and cooked sea vegetables if children like them.

In Food and Healing, Annemarie Colbin explains what sugar is and why it causes so much damage to the health of children and adults. White sugar, like white rice and white flour, goes through an industrial refining process: its juice is extracted from sugar cane, then filtered and boiled until it has been separated from all of its water, minerals, vitamins, protein and fiber, all of which the body needs to digest and metabolize the sugar. Because it lacks those nutrients, refined sugar becomes what Colbin calls a "naked carbohydrate," and so the body will draw them from other foods in the same meal or the body's tissues. Thus when refined white sugar is consumed, there is loss of stored B vitamins, calcium, phosphorus, iron, and other nutrients from the body. The loss of calcium stored in teeth weakens them and makes them more susceptible to bacterial attack/cavities. Also, this nutrient loss from refined sugar consumption can produce hunger for the missing nutrients and provoke great sugar-eating binges. On food labels, sugar is often identified as lactose, maltose, fructose, sucrose, and others. Glucose is the name of sugar found in the blood.

Colbin points out that if you eat meat, you need to digestively balance it with white sugar and vice versa, and that serious problems arise when the amount of sugar eaten is more than the amount needed to balance the meat. Sugar is as addictive as a drug because eating a small amount creates a desire for more sugar and because quitting sugar "cold turkey" brings on withdrawal symptoms that can last for an extended period of time. Typical withdrawal symptoms include strong cravings, fatigue, depression, mood swings, and sometimes headaches. Excessive sugar consumption is believed to be involved in such very common problems as hypoglycemia or hyperinsulinism, diabetes, heart disease, dental caries, high cholesterol, obesity, indigestion, myopia (nearsightedness), seborrheic dermatitis, gout, genetic narrowing of pelvic and jaw structures, crowding and malformation of teeth, hyperactivity, lack of concentration, depression, and anxiety. Colbin notes that these problems result when the sugar intake provides more "naked carbohydrates" than are needed to balance the animal protein intake. Since white flour also provides additional "naked carbohydrates," only a small amount of sugar can create an excess amount in the body.

It is important that children eat three meals a day and not skip breakfast. Studies have shown that children and teens that skip breakfast have more trouble concentrating, do not perform as well in school, and often have later problems with heart disease . Obesity is common in children who skip breakfast.

While the obesity problem in today's youth can be blamed on a number of factors, including larger food portions for adults and children, convenient salty and sugary snack foods, and cheap and convenient fast food, much attention has been focused on the role of the nation's schools. There are fewer physical education classes because of more emphasis on academic classes and those gym classes that remain have too much standing around and not enough activities that interest the children, say some experts. School lunches generally have not provided healthy or balanced nutrition but instead have consisted of highly refined, processed foods that are full of additives and simple carbohydrates, which do not provide good nutrition or energy. In addition, many schools also offer "snack bars" or vending machines with sodas and sugary, fatty, or salty snacks. Many children have been choosing these snacks over the prepared school lunches.

To counter this problem in schools, the Healthy Schools Summit was held in October 2002. It consisted of representatives from more than 30 national education, fitness, nutrition, and health organizations, as well as 450 school administrators, government leaders, food service directors, counselors, dietitians, nurses, and health and fitness teachers. Since that time, many school districts around the country have been working to improve their physical education programs and to remove or change the selections in vending machines and snack bars on school campuses. Parents can check with their children's schools or pack healthy lunches from home with foods their children like to ensure they eat well while at school.

Children who are very active and participate in organized sports need a particularly healthy diet. For extended energy, they should eat many complex carbohydrates, such as unrefined rice, whole grain pasta and bread, and whole grain cereal. While all children need to drink plenty of water, those who participate in sports need to drink even more. Some experts say an easy formula to remember is one cup of fluid for every one-half hour of physical activity.

At home, some parents choose convenient snack and fast foods because often, both parents work long hours. Along with bigger portions and increased time spent in front of the television instead of out being physically active, today's youth are becoming obese from receiving and growing accustomed to less nutritional foods. Many experts say that getting children up off the couch and watching their snack choices helps. Also, many sources can help parents find healthier alternatives to fast food meals for their families. Suggestions include cooking healthy meals on weekends and freezing them for busy weekdays and looking for cookbooks or online sources of quick and healthy recipes. Simply cooking with less fat and using baking, roasting or poaching methods instead of frying helps children and adults. Also, offering children healthy snacks to last them until mealtime will keep them from reaching for poor snack choices and make them less likely to overeat at the evening meal.

For a variety of reasons, some children follow vegetarian diets. Some people are concerned that a vegetarian diet is harmful for children, but generally, if a child aged two or older still follows the recommended Food Guide Pyramid and makes good food choices, a vegetarian diet can be healthy. In fact, 2% of children ages six to 17 never eat meat, fish, or poultry. If a vegetarian child needs a vitamin or mineral supplement, a physician or professional nutritionist can help determine the proper level of supplement needed.

Precautions

Parents are sometimes cautioned by nutritional experts not to turn mealtimes and eating into a battle of wills. Offering a variety of healthy choices allows children to select favorite foods from among those that are good for them and to balance foods containing a number of vitamins and minerals. Research in 2004 showed that taste for certain foods probably develops while people are still infants. In fact, infants in the study who had been exposed to the flavor of carrots through their mothers' breast milk later ate more of a carrot-flavored cereal that those who had not been exposed to carrots as infants. The researchers said that encouraging children to eat more fruits and vegetables as early as possible was helpful.

Many physicians and medical researchers have cautioned parents not to turn to fad diets for their children's weight problems. Many of the diets and diet products on the market have not been proven by clinical studies to be effective in the long term for adults and therefore they certainly have not been proven safe or effective as a solution to weight problems in children. The best solution for childhood obesity is a combination of activity, a balanced diet that follows the AMA/USDA guidelines for food groups and portions, and involvement of a physician, dietician, or other trained professional as needed. A further caution concerning dieting is the concern that as young children enter adolescence, too much worry about weight and appearance can cause social anxieties and lead to eating disorders such as anorexia and bulimia.

When changing a young child's diet, it should be done slowly, particularly when introducing fiber, and with the help of a physician, dietician, or nutritionist Too much fiber can interfere with the body's absorption of vitamins and minerals.

Children who do not eat enough food and do not get enough nutrition suffer from severe undernourishment, or malnutrition. Each year, more than six million children under the age of five years die around the world as a result of hunger. Malnutrition also can make a child more susceptible to a number of diseases. Worldwide, it is estimated that food insecurity affects 815 million households, mostly in developing countries. However, in 2003, a report showed that at least 10% of U.S. households also don't have enough food and about 3% report hunger at home. In this case, it is not the sort of hunger a person feels when they eat a late lunch but the kind of painful sensation someone gets from repeated or involuntary lack of food.

There are parents and health professionals, both traditional and alternative, who feel children should have vitamin/mineral supplements to stay healthy. However, there are also parents and health professionals who believe that when children eat a balanced diet of wholesome foods, they seldom need vitamin supplements; that individual vitamins and minerals should be taken, like medicine, when a deficiency has been created by a diet imbalance; and that when such a deficiency has been corrected, they should be discontinued.

If children are not eating a healthy diet and are being given a vitamin/mineral supplement, it is important to keep chewable vitamins out of reach of young children, as their appealing taste may be irresistible and dosage needs to be controlled according to directions. Children with poor appetites or erratic eating habits also may benefit from vitamins and minerals. It is best to check with a pediatrician, dietician or nutritionist for dosing.

Some parents and health professionals feel that vegetarian children may benefit from vitamin/mineral supplementation because they may lack some iron and zinc normally obtained through meat products and/or fish. Other substantial sources of iron are eggs, whole-grain breads and cereals, leafy and other vegetables, potatoes, fruit and milk. Foods containing vitamin C (broccoli, Brussels sprouts, collards, kale, parsley, sweet peppers, strawberries, grapefruit, melons, tangerines, potatoes, and more) will increase absorption of iron in non-animal foods. Vegetarian sources of zinc are eggs, legumes, and whole grains. Zinc deficiency has been found in populations whose intake is derived solely from cereal sources, but in recent studies, vegetarians had adequate zinc levels. Those children who avoid dairy products, although it is difficult to get enough, may get calcium from broccoli, leafy green vegetables like kale, canned salmon and sardines including the bones, and soy products. If a child's physician or qualified nutritionist feels a supplement is necessary, he/she should recommend the dosage.

Children often don't recognize feelings of thirst and have to be encouraged to drink before becoming thirsty. If a child's urine is clear or the color of pale lemonade, he or she is drinking enough fluids. Dark urine the color of apple juice indicates too little hydration and the child is in danger of dehydration or heatstroke.

Side effects

Only the fat-soluble (capable of being dissolved in fat or oil) vitamins A, D, K and E have side effects that are potentially, though rarely, toxic (poisonous).

In their book The Real Vitamin & Mineral Book, Sheri Lieberman and Nancy Bruning state, "The facts are that only a few vitamins and minerals have any known toxicities, all of which are reversible, with the exception of vitamin D. Anything can be harmful if you take enough of iteven pure water. But vitamins and minerals are among the safest substances on earth. The amounts needed to become toxic are enormous." They add that being on medication or having a medical condition can influence vitamin/mineral requirements and indicate that when one's physician is not well-versed in nutrition, it is ideal to have him work with a qualified nutritionist.

With regard to vitamin D, they indicate, "According to several studies, up to 1,000 IU per day of vitamin D appears to be safe. Both the beneficial and adverse effects of exceeding this amount are controversial. Overdosing of vitamin D is irreversible and may be fatal. Symptoms of too much vitamin D are nausea, loss of appetite, headache, diarrhea , fatigue, restlessness, and calcification of the soft tissues (insoluble lime salts in tissue) of the lungs and the kidneys, as well as the bones." Vitamin D (400 IU) is usually sold with vitamin A (5,000 IU) in a tiny tablet or capsule.

Lieberman and Bruning say that active vitamin A from fish liver oil or synthetic palmitate is stored in the liver; that 15,000 IU would cause problems in infants; but that 100,000 IU of active vitamin A would have to be taken daily for months before any signs of toxicity (state of being poisonous) appear. Vitamin A in the form of beta-carotene can be taken without any risk of toxicity.

At doses of 8001,200 IU per day, Lieberman/Bruning found no well-documented toxicity of vitamin E. At doses of over 1,200 IU per day, adverse effects such as flatulence, diarrhea, nausea , headache, heart palpitations, and fainting have been reported, but were completely reversible when dosage was reduced.

Vitamin K is easily obtained by the body from a healthy diet and deficiencies are rare, especially in children. It is given prophylactically to newborn infants to prevent hemorrhage and before surgery to people with blood-clotting problems. Lieberman/Bruning describe the major effect of too much vitamin K as an anemia where red blood cells die more quickly than usual and cannot be replaced by the body.

Some children have severe food allergies. It is important to watch for signs of allergies in very young children in particular, since they are eating many foods for the first time. Signs of food allergies can range from mild to severe. A child may, for instance, eat peanuts or shellfish and immediately show signs of a severe reaction, such as swelling and trouble breathing. Other food allergies may be less obvious but may occur from common foods found in many everyday products such as milk, eggs, wheat, or soy. If a child appears to have a severe reaction and has trouble breathing, the parent or caregiver should seek immediate medical attention, since the allergic reaction may be serious. If a child has ongoing problems such as eczema or other allergic reactions or signs of intolerance to foods, the parent may choose to seek help from a registered dietician and/or an allopathic physician who specializes in allergies. The allopathic physician may test the child first to determine the source of the allergies. The dietician will work with the family to help plan ways to meet nutritional needs while avoiding foods that cause allergic reaction or intolerance.

The parent of an allergic child can also choose to seek help from a homeopathic or naturopathic physician. Andrew Weil, M.D., author of Spontaneous Healing, a New York Times number one bestseller that sold well over one million copies, believes that the body can heal itself and believes allergies are learned responses of the immune system to environmental agents that are not necessarily harmful. Weil says treatment should focus on calming an over-reactive immune system in order to alleviate allergy symptoms. Allergies can and are frequently "healed." However, traditional allergy medications tend to be "more or less" toxic to the body and can increase an allergic response over time.

To increase the likelihood of spontaneous healing, Dr. Weil made the following recommendations. Dietary modification to reduce allergic responses: following a low-protein diet; cutting down on animal protein in general; eliminating cow's milk and products made from it because they are known to irritate the immune system; and eating organically grown foods as much as possible to avoid agricultural chemicals that cause immune system reaction. Regular use of quercetin, a natural product from buckwheat and citrus fruits, that stabilizes cell membranes that release histamine, which is involved in many allergic reactions. Quercetin is a preventative and Dr. Weil recommends it be used regularly. The recommended dose is 400 mg twice a day between meals. For hay fever, the freeze-dried extract of the herb stinging nettle, one to two capsules every two to four hours as needed, he says will control symptoms with none of the toxicity of anti-histamines or steroids. He also recommends a safe nasal spray, Nasalcrom, which works like quercetin. In the home, environmental methods like installing air filters can reduce allergic effects on and relieve the immune system. And finally, some allergic reactions indicate that high brain levels are involved in misdirected immune system response, and mind/body intervention is suggested.

Research & general acceptance

The AMA has based many of its food choices on the Dietary Guidelines for Americans, which were developed through research by the U.S. Department of Agriculture and the U.S. Department of Human Services. Input for the guidelines comes from a number of resources, including national surveys from the Centers for Disease Control (CDC).

As for children and the general public, accepting the importance of nutrition is another story. A 2003 study from the American Dietetic Association reported that preteens and their parents weren't concerned about preteens' weight being a health risk. Children and parents related obesity more to food than to physical activity and many overweight children said they didn't have much opportunity for physical activity.

Training & certification

Qualified dieticians and nutritionists may have a bachelor's, master's or a doctoral degrees in nutrition and dietetics from an accredited college. They also are required to constantly update their knowledge with continuing education. Through the American Dietetic Association, these professionals can gain certification in their fields, including a certificate of training in childhood and adolescent weight management. Pediatricians obtain M.D. or D.O degrees and some specialize in childhood diseases and treatment. In the field of alternative medicine, parents may choose to seek treatment from naturopaths and homeopaths.

Andrew Weil, M.D. in Spontaneous Healing points out the benefits of naturopathic medicine by saying that naturopaths go beyond the impression that they are 'New Age.' "Naturopathy comes from the old tradition of European health spas with their emphasis hydro (water) therapy, massage, and nutritional and herbal treatment." Naturopaths are well trained in the sciences and have more experience with nutritional and herbal medicine that allopathic physicians may not have. Naturopathy is based on a general philosophy that focuses on the body's natural healing potential in an attempt to circumvent the use of drugs and surgery; however, naturopathic physicians may focus on different styles, using such therapies as acupuncture, bodywork, herbalism, and homeopathy . They are licensed in only a few states in the United States, mostly in the West. According to Dr. Weil, "Good naturopaths are worth consulting for childhood illnesses, recurrent upper respiratory infections and sinusitis, gynecological problems, and all ailments for which conventional doctors have only suppressive treatments. Naturopaths can be valuable as advisors to help people design healthy lifestyles." To find a naturopathic physician in their area, parents can contact the American Association of Naturopathic Physicians, 601 Valley Street, Suite 105, Seattle, Washington 98109, (206) 298-0126.

With regard to homeopathy, Dr. Weil also has positive feedback for the discipline. Homeopathy is a system that has a two hundred year old history. Homeopaths use diluted natural remedies work on the body's energy field to encourage healing. Homeopathic physicians can be M.D.s, osteopaths, naturopaths, chiropractors, or lay persons. If a parent wishes to consult an alternative practitioner for homeopathic advice, the National Center for Homeopathy can be contacted at 801 North Fairfax Street, Suite 306, Alexandria, Virginia 22314, (703) 548-7790.

Resources

BOOKS

Colbin, Annemarie. Food and Healing. New York: Ballantine Books, 1986, 1996.

Colbin, Annemarie. The Book of Whole Meals. New York: Ballantine Books, 1983.

Colbin, Annemarie. The Natural Gourmet. New York: Ballan-tine Books, 1989.

Dufty, William. Sugar Blues. New York: Warner Books, 1978.

Estella, Mary. Natural Foods Cookbook. New York: Harper & Row, 1985.

Hewitt, Jean. The New York Times Natural Foods Cookbook. New York: Avon Books, 1972.

Kordich, Jay. The Juiceman's Power of Juicing. New York: Warner Books, 1993.

Lappe, Frances Moore. Diet for a Small Planet. New York: Ballantine Books, 1991.

Lieberman, Sheri, and Nancy Bruning. The Real Vitamin and Mineral Book. New York: Avery Publishing Group, Inc., 1990.

Mindell, Earl, Ph.D, R.Ph. Vitamin Bible for the 21st Century. New York: Warner Books, 1999.

Walker, Norman W., D.Sc. Fresh Vegetable and Fruit Juices. Prescott, Arizona: Norwalk Press, 1970.

Weil, Andrew, M.D. Spontaneous Healing. New York: Ballan-tine Books, 1995.

PERIODICALS

Berler, Ron. "The Problem is Big: More Kids than Ever are Overweight. We'll Tell You About the Crisis, Offer Some Solutions, and Explain Why Controlling Your Weight Can Make You a Better Athlete." Sports Illustrated for Kids (October 1, 2003):60.

"Food Insecurity." Pediatrics (February 2003):357358.

"Kids Don't Think Obesity is a Health Problem." Nutrition Today (July-August 2003): 115116.

McCook, Alison. "Food Taste Acceptance 'Programmed' in Infancy." Reuters Health (April 5, 2004).

ORGANIZATIONS

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (888) 227-1770. <http://www.aap.org/family>.

American Herbalists Guild. P.O. Box 1683. Soquel, CA 95073. 408-464-2441.

American Holistic Medical Association. 5728 Old McLean Village Drive. McLean, VA 22101-3906. (703) 556-9728.

International Food Information Council. 1100 Connecticut Avenue, NW, Suite 430, Washington, DC, 20036. (202) 296-6540. <http://www.ific.org>.

KidsHealth/Nemours Foundation. 4600 Touchton Road East, Building 200, Suite 500, Jacksonville, FL 32246. <http://www.kidshealth.org>.

U.S. Department of Agriculture and U.S. Department of Health and Human Services. (888) 878-3256. <http://www.usda.gov/FoodAndNutrition>.

OTHER

BMI For Children and Teens. National Center for Chronic Disease Prevention and Health Promotion. [cited June 16, 2004]. <http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm>.

Healthy Food Choices: Six to 12 Years. American Medical Association. [cited June 16, 2004]. <http://www.medem.com>.

Healthy Food Choices: Two to Five Years. American Medical Association. [cited June 16, 2004]. <http://www.medem.com>.

Report Card on the Diet Quality of Children Ages Two to Nine. Publication of the USDA Center for Nutrition Policy and Promotion. [cited June 16, 2004]. <http://www.cnpp.usda.gov>.

Ruth Ann Carter

KEY TERMS

Megavitamin therapy
Also called orthomolecular medicine, megavitamin therapy provides large doses of vitamins and minerals to treat certain conditions or diseases.

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Citation styles

Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

http://www.mla.org/style

The Chicago Manual of Style

http://www.chicagomanualofstyle.org/tools_citationguide.html

American Psychological Association

http://apastyle.apa.org/

Notes:
  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.